Oral
Answers to
Questions

Environment, Food and Rural Affairs

The Secretary of State was asked—

Sewage Discharges: East Devon

Simon Jupp: What steps her Department is taking to help reduce sewage discharges in East Devon constituency.

Therese Coffey: My hon. Friend will know, regrettably, of the poor environmental performance of South West Water, with the second highest number of pollution incidents in the country. That is completely unacceptable for his constituents, and South West Water can, and must, do better. Meanwhile, it is subject to an ongoing criminal investigation led by the Environment Agency, which must be allowed to run its due course.

Simon Jupp: The Conservative party and Government have brought in the toughest ever crackdown on sewage spills. We are holding failing water companies to account, including the one-star rated South West Water, which was fined £13 million last year, and rightly so. Does my right hon. Friend agree that South West Water must clean up its act and our water?

Therese Coffey: My hon. Friend is absolutely right. South West Water continues to be a poor performing company, which is unacceptable. That is why I called in the worst performing water companies at the end of last year, including the chief executive of South West Water. Those companies must take urgent steps to significantly reduce their pollution incidents, and we will ensure that they continue to be held to account. That is why I have asked water companies to provide individual reduction plans for each of the combined sewer overflows.

Richard Foord: Sewage discharged into the River Otter flows through east Devon and my neighbouring constituency. The Government have adopted a Liberal Democrat amendment to the UK Infrastructure Bank Bill, which will make water companies produce costed, time-limited plans to stop sewage discharges before they can borrow taxpayers’ money. Although I am pleased that the Secretary of State and her colleagues have adopted my amendment, I wonder why they did not think of it themselves.

Therese Coffey: I do not think it is the intention of the UK Infrastructure Bank to be investing in the water companies —that is not expected to be its purpose. The amendment—dare I say it?—was perfectly nice, and of course the Government were happy to recommend it. This is important. It has been an ongoing issue for some time, and Liberal Democrat people have been water Ministers as well. We need to face these issues, and the fact that stuff has not been tackled. I am pleased that this Conservative Government are getting a grip and making a much harder effort to ensure a reduction in sewage pollution incidents.

Lindsay Hoyle: I call the shadow Secretary of State, Jim McMahon.

Jim McMahon: The Environment Secretary first said that it was not a priority to meet water bosses, and then she said that it was and that she really did care—or words to that effect. She then said that she would come forward with a plan and big fines, but there were no plans and no fines. She then said that there would be a plan, but that the water companies will do it, not the Government, and that there might be fines, but only if the water companies agree to that. We now discover that Ofwat has watered down the rules intended to hold water companies to account, actively removing any reference to the consideration of local communities and local economies. On a scale of one to 10, how does the Secretary of State rate her Government’s record on ending the Tory sewage scandal?

Therese Coffey: I have great confidence in the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Taunton Deane (Rebecca Pow), who continues to meet water companies, as do I. If the hon. Gentleman goes back and looks at the record of the Labour Government, he will see that they failed to deal with the urban waste water initiatives. The European Commission contacted them, took action against them, and took the Labour Government to court for failing to deal with sewage. That is what happened; that is the real history. When the Conservatives and the coalition Government came into power, we started working on leaks and making strategic policy statements, and we started the monitoring. None of that happened under a Labour Government. The hon. Gentleman can spew out as much rubbish as he wants, but the reality is that the Labour Government did nothing about it. This Conservative Government are fixing it, making it harder, and that is what we will continue to do.

Jim McMahon: Oh my God. I have confidence in the Under-Secretary of State for Environment, Food and Rural Affairs, the hon. Member for Taunton Deane (Rebecca Pow), who is doing a good job in very difficult circumstances to try to make progress, but I do not agree with the Environment Secretary passing the buck to a junior Minister, which is not on. Ultimately, those at the top take responsibility. It is high time the Secretary of State did just that.
I am proud of the Labour Government’s record. We had the cleanest water and the cleanest air since the industrial revolution. That is the Labour record, and it is a scandal that it was not built on further. The abuse of water does not stop there. Let us hear from the North East Fishing Collective, which had the door slammed  on it on the scandal of crustacean die-offs on Teesside. It is concerned that livelihoods, jobs and generational pride have been impacted by the Government’s indifference:
“The entire fishing fleet in Hartlepool is finished. There’s no business left. They failed us when we begged them to listen, so now we will have to fight”.
I ask the Secretary of State, for the second time, to rate her Government’s performance on the water scandal that is polluting our country.

Therese Coffey: The hon. Gentleman should withdraw his earlier comments, because he has, perhaps unintentionally, misled the House. I hope he has the grace to withdraw.
Leading scientific advisers reviewed the crustacean die-offs, and it was published to the Environment, Food and Rural Affairs Committee and the House. We understand that a novel pathogen is the most likely explanation for what happened in the north-east. I continue to work with the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Taunton Deane, and I take this matter very seriously, but I am conscious that, unlike the Labour Government who in their responses to the European Commission denied that there was a problem and were successfully taken to court, this Government have continued to act and will continue to do so.

Food Costs

Gavin Newlands: What recent discussions she has had with Cabinet colleagues on the rising cost of food.

Mark Spencer: The Department for Environment, Food and Rural Affairs works closely with other Departments and industry to keep abreast of price trends for food products. We are monitoring the situation and taking relevant action to maintain an efficient food supply chain by mitigating against potential burdens or frictions that could otherwise drive up food prices.

Gavin Newlands: I am tempted to ask the Minister the price of a pint of milk, but no doubt his officials have put that in his brief.
As UK supermarket price inflation hits record highs, consumers are paying just under £800 more on their annual shopping bill, which is in part due to Brexit and the rising cost of animal feed, energy and fertiliser, with agricultural costs rising by almost 50% since 2019. Although farmers are fundamental to food production, they are bearing the brunt of the cost of the food crisis. Farming is an energy-intensive industry, so why is it not getting the same level of support as less energy-intensive sectors? Has the Minister met the Chancellor to discuss how better to support domestic farming?

Mark Spencer: The hon. Gentleman tries to blame Brexit, but even he will recognise that Putin’s invasion of Ukraine caused enormous ripples around the world, not only in energy prices but in food prices. Ukraine was the breadbasket of Europe and supplied huge volumes of cereals. Of course, rising global gas prices caused a rise in the cost of fertilisers. The Government recognised all that and tried to help farmers through this process and to assist them to produce great-quality food.

Andrew Bridgen: I draw the House’s attention to my entry in the Register of Members’ Financial Interests, as I am a major share- holder in a food production company.
What assessment has my right hon. Friend made of the National Farmers Union’s call to protect home-grown food production?

Mark Spencer: We have been at this week’s NFU conference to talk directly to the NFU and to listen to farmers’ concerns. We recognise that there are huge pressures on UK domestic food producers and farmers, which is why we are helping them with grants to invest to make their businesses sustainable for the future.

Lindsay Hoyle: I call the shadow Secretary of State.

Jim McMahon: Farmers from across the country met in Birmingham this week—the right hon. Gentleman and I sat on the same table for dinner—at an unprecedented time, with pressures seemingly coming from every direction to create a perfect storm. Although there might have been differences about the scale of the impact, there was consensus that the Environment Secretary had a pretty bad day at the office. Some described it as a “slow-motion tractor crash” or “calamity Coffey.” Joking aside, it was an insult to the very foundation of our food security and hard-working British farmers.
Everyone has the right to have a bad day at the office —I have had a fair few myself—but we have a responsibility to reflect on it and to right the wrong. Will the Environment Secretary, not the Farming Minister, use this opportunity to apologise?

Therese Coffey: You know I cannot respond now.

Jim McMahon: I am very happy for the Farming Minister to apologise on the Secretary of State’s behalf for her outrageous display at the NFU conference in Birmingham yesterday. Will he use this opportunity?

Mark Spencer: The hon. Gentleman will know that the Secretary of State cannot answer this question, because of parliamentary procedure; I am obliged to answer, because I am answering—

Lindsay Hoyle: Let me help. The Secretary of State will be coming in at topical questions, where she can open with a statement and can respond to anything she wants to then. I also say to both sides that I am really bothered that it is nearly quarter to 10 and we are still only on Question 2. Let us make progress.

Mark Spencer: Thank you, Mr Speaker. The Secretary of State can speak for herself, but we had a successful meeting with farmers in Birmingham. There were some robust exchanges, but that is what we welcome and we engaged with. We continue to work with the NFU and other groups that represent the farming industry.

Jim McMahon: We are going to have the urgent question on food security a bit later, so I will not labour that at this point. I also thank you for granting the UQ,  Mr Speaker. Will the Minister confirm whether the Government have convened a cross-government committee to look at food security in this country and, in particular, the levers they can deploy? I am referring to financial support for farmers, support for energy-intensive food producers, and dealing with labour shortages and all the other issues about which, as he would have heard in Birmingham, farmers feel very frustrated, as it does not feel as though progress is being made on them.

Mark Spencer: Of course, there are Cabinet Office committees that look at all these challenges, but we in the Department continue to meet retailers on a regular basis. We are convening a roundtable with supermarkets to see how we can assist with those supply chain challenges that we face. We are gripping the situation and trying to assist where we can. It is down to the market to supply where it can, but there are huge challenges, including those in Morocco and Spain that have caused disruptions to food supplies in the UK at this moment.

Lindsay Hoyle: I call the Scottish National party spokes- person.

Patricia Gibson: According to the Office for National Statistics, the consumer prices index rose by 9.2% in the 12 months to December last year. Food inflation is at its highest since the 1970s, reaching 16.9%, making daily essentials such as butter, milk, pasta, eggs and cooking oil, unaffordable for those who are struggling in the cost of living crisis. Of course, that comes alongside the prospect of rationing. Food inflation is not going to fall for the foreseeable future, so what plans will the Minister put in place to ensure that affordable supplies of food can be made available? What steps will he take to make sure that food inflation falls?

Mark Spencer: The hon. Lady will be familiar with the huge package of support that the Chancellor of the Exchequer has put in place for families across the country, including in her constituency in Scotland, to help people with the rising cost of energy and food. That is the right thing to do; it supports those families with those challenges. There is also cash available for local authorities to try to help where the situation is very challenging.

Withdrawal from EU Single Market: Food Production

Neale Hanvey: What recent assessment she has made of the impact of the UK’s withdrawal from the EU single market on trends in the level of food production.

Mark Spencer: The Government have delivered the first free trade agreement the EU has ever reached based on zero tariffs and zero quotas, and our recent food strategy sets out how we will support a prosperous agrifood sector.

Neale Hanvey: National Farmers Union of Scotland president Martin Kennedy recently highlighted the unprecedented period of change, cost and uncertainty for Scotland’s farmers and crofters driven by Brexit and now compounded by energy costs and fertiliser costs. Last year, I met farmers from across my constituency.  They were frustrated by a lack of clarity on a replacement for the common agricultural policy, and our beef herds are now decreasing in numbers. This Government were elected on a pledge of matching EU funding pound for pound, but that has not materialised. Where is the money and when is it coming?

Mark Spencer: That simply is not true; £2.4 billion is the budget we have committed to in the manifesto, and we are making sure, through this Parliament, that that money continues to go to farmers. Lots of the issues the hon. Gentleman raises are devolved; his own Government are not delivering for the farmers in Scotland. In England, we are rolling out those plans—grants for farmers to invest in their businesses, and help to assist with their environmental schemes and to make sure that they are prosperous. I only hope that he can influence the Scottish Government to give the same level of support to his farmers.

Climate Change: Nature-based Solutions

Kerry McCarthy: What discussions she has had with the Secretary of State for Energy Security and Net Zero on her Department’s future role in promoting nature-based solutions to climate change.

Trudy Harrison: Throughout our net zero strategy, and in more detail across the 10 goals and 262 pages of our environmental improvement plan, we have clearly set out that nature-based solutions to net zero are at the heart of everything we are doing.

Kerry McCarthy: Coastal wetlands have huge potential both in terms of biodiversity and as carbon sinks, but there is an evidence gap that means we cannot exploit their potential by attracting full private and public sector investment. The right hon. Member for Kingswood (Chris Skidmore) said in his recent net zero review that that needs to be part of the greenhouse gas inventory, but we need the evidence base. Can the Minister clarify whose job it is to conduct that work so that we can fully maximise the potential of wetlands? Is it her Department, or is it the new Department for Energy Security and Net Zero?

Trudy Harrison: I reassure the hon. Lady that I whole- heartedly agree with her on the value of wetlands. I recently attended the Slimbridge Wetland Centre with the Wildfowl & Wetlands Trust and saw for myself how beneficial wetlands can be. In direct response to her question, the responsibility in DEFRA lies with me. I look forward to meeting her to explain exactly how we are creating more wetlands and how nature-based solutions will feature throughout our net zero and other strategies.

Rural Farmers

Jamie Stone: What steps she is taking to support rural farmers.

Wendy Chamberlain: What steps she is taking to support rural farmers.

Mark Spencer: Our environmental land management schemes are now open to farmers. The schemes collectively pay farmers to deliver climate and environmental outcomes alongside food production. We continue to evolve those offers, recently updating the countryside stewardship payment rates and bringing forward six new sustainable farming incentive standards.

Jamie Stone: The right hon. Gentleman is, I know, a horny-handed son of the soil, so he will know that some of the finest seed potatoes are grown in Easter Ross in my constituency. Many of those seed potatoes are in turn sold to English farms in Lincolnshire and suchlike—I might say that is one benefit of the Union. May I press the Minister to tell me what support can be given to those farmers in England to encourage them to grow more spuds such as Maris Pipers and hence to buy more seed potatoes from the farmers in my constituency?

Mark Spencer: I draw attention to my declaration in the Register of Members’ Financial Interests, but I join the hon. Gentleman in paying tribute to Scottish seed potato producers. They are undoubtedly the best seed potatoes available anywhere in Europe, and I know that is recognised throughout the industry. That is why we are supporting farmers across England to continue to grow great British potatoes based on Scottish seed potatoes.

Wendy Chamberlain: A tight labour market is a reality in agriculture and has been for some time and, although there may be other factors, we know Brexit is at the heart of it. That is why we have a seasonal agricultural worker scheme, but the Government continue to make decisions on that scheme on a short-term basis, too late for farmers to plan, so that they cannot invest in crops or machinery. When will the Government commit, working via the Home Office, to a five-year rolling programme so that farmers can make the right decisions for their staff?

Mark Spencer: The hon. Lady will be aware that this year we have granted an extra 15,000 visas through the seasonal agricultural worker scheme. We have also committed to those people being guaranteed a minimum of 34 hours a week, paid at the national minimum wage. There is also the option of an extra 10,000 visas if the industry requires them. We will continue to monitor, with the industry, how the scheme is working and to support the farmers who require that labour.

Richard Bacon: One of the most important roles for rural farmers is their ability to offer up land for affordable housing for rural people. What discussions has my right hon. Friend had with the new housing Minister about the more vigorous implementation of the Self-build and Custom House- building Act 2015—and if he has not yet had any, when does he plan to do so?

Mark Spencer: My hon. Friend is very astute at getting his pet topic into DEFRA questions; I pay tribute to the work he has done on self-build. Of course, we always have discussions with the Department for Levelling Up, Housing and Communities, whose responsibility it is, about land use and we will be producing a land use framework later this year.

Lindsay Hoyle: I call the shadow Minister.

Daniel Zeichner: The Minister sometimes characterises my line of questioning as a touch gloomy, so I will try to cheer him up this morning by saying how pleased I was to hear his announcement at the NFU conference that the £2.4 billion per annum of agricultural support would be ring-fenced and that, if there was underspend in one year, it would be carried forward into future years. I am sure we are delighted that the Treasury has become such a kind, benevolent, caring organisation, but will he just repeat that promise in the House this morning, and maybe get one of his officials to write to me to point to where in his Department’s accounts that money is, so we can all keep an eye on it?

Mark Spencer: I am glad that we are making progress. If the hon. Gentleman had only read the Conservative party manifesto at the last election, he would have known that and would not be as gloomy. I encourage him to continue monitoring the Conservative party manifesto.
I am happy to confirm, as I did for the hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey), that £2.4 billion is ringfenced for the support of farmers—[Interruption.] Where is it? It is being spent at the moment, as the hon. Member for Cambridge (Daniel Zeichner) will know. Some of it is being spent on the basic payment scheme, which comes down over seven years, and we are increasing payments through environmental land management schemes as the basic payment comes down. It is a very simple graph: as one comes down, one goes up. We are supporting farmers up and down this country.

Lindsay Hoyle: I call the SNP spokesperson.

Patricia Gibson: Brexit barriers are impacting on exports, and labour and skills shortages across the economy have exacerbated underlying inflation, worsening the economic outlook for farmers, who are already grappling with labour shortages, rising energy and annual feed costs, and the appalling spectacle of unpicked food rotting in fields. A one-size approach to labour shortages does not fit Scotland, whose population is actually falling. What consideration will the Minister give, with Cabinet colleagues, to the Scottish rural visa pilot scheme, which is desperately needed to address Scotland’s specific needs?

Mark Spencer: As I said to the hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey), the Government recognise that there are challenges with labour supply. That is why we increased the number of visas to 45,000, with the option of an extra 10,000 if required. The industry has not called on the extra 10,000 visas at this time, but we remain ready to deploy them if the industry can demonstrate that they are required.

Bathing Waters: England

Luke Pollard: When she will next update the list of designated bathing waters in England.

Rebecca Pow: The list of designated bathing waters is updated annually, as I am sure the hon. Member knows. We will give updates for the new list in May.

Luke Pollard: As a keen wild swimmer in Devil’s Point and Firestone bay in Plymouth sound, which is the country’s first national marine park, I have been working with Plymouth City Council to declare that really special piece of water a designated bathing water. May I ask the Minister to don her wetsuit and join me in the sea, where I can show her not only that incredible piece of water and the expanding access to it—especially for people from poorer communities—but, importantly, the raw sewage pipe that occasionally emits appalling human waste into a special and environmentally important bit of our sea?

Rebecca Pow: I do wear a wetsuit when I go swimming in the sea—I am a bit of a coward, but I love to put my wetsuit on and go swimming in the sea.
As the hon. Gentleman knows, he will have to wait until May to see where we go with that particular designation, but we already have 421 designated bathing sites in England as of last year—that number has gradually been going up. The good news about those sites is that 93% of them are classed as “excellent” and “good”, so their record is extremely good. I will take a rain check on whether I join him for a swim.

Christopher Chope: Why are there only 421 such sites? People can go wild swimming anywhere in England and other parts of the United Kingdom. Is this whole designation scheme not essentially a rationing scheme? Why do the Government not abandon it and enable people to swim in bathing waters anywhere?

Rebecca Pow: To be quite honest, one can swim wherever one wants; it is just that there is a process for what we call designating bathing waters. In the application for that, one has to demonstrate that there is sufficient interest in using that site—that high numbers of people want to use it—and that there are car parking facilities and public facilities, including loos and so forth. That is all part of encouraging designated sites, but it is not to say that people cannot choose, in their own right, to swim wherever they want.

Fish Stocks

Sheryll Murray: What steps her Department is taking to protect fish stocks.

Mark Spencer: Our landmark Fisheries Act 2020 sets out the legal framework within which we manage fish stocks in UK waters, including fisheries management plans for key stocks. We work with industry and stakeholders, ensuring that precious fish stocks are managed to benefit our marine environment, fishing industry and coastal communities.

Sheryll Murray: I recently hosted the National Federation of Fishermen’s Organisations in Parliament, as the Minister will know, so that it could launch a report highlighting concerns within the fishing industry across the UK  about the loss of fishing grounds to an array of pressures, of which offshore wind and marine protected areas topped the list. What assurances can the Government give that they will speak to the NFFO and ensure that fishing is an important factor?

Mark Spencer: I pay tribute to my hon. Friend for all that she does for the fishing sector. We welcome the NFFO’s “Spatial Squeeze in Fisheries” report, which highlights the need for a holistic approach to spatial planning. I meet regularly with the NFFO to discuss a wide variety of issues, including spatial prioritisation and the concerns outlined in that report.

Alex Cunningham: The Secretary of State and the Minister need to travel to Teesside to meet people from the fishing and wider community who are still looking for answers to the ongoing deaths of crustaceans, fish and other sea life off the coast. If I set it up, will they come to Teesside and explain what they are going to do next to find out what is causing this ongoing crisis?

Mark Spencer: I share the hon. Gentleman’s desire to know the cause of that terrible disaster. The scientists have looked at this, done a report and come to the conclusion that it was probably a pathogen that is very difficult to detect. Unless there is another event, which I sincerely hope there is not, we may never know the cause of this event.

Global Food Security

Edward Leigh: What steps her Department is taking to help strengthen long-term global food security.

Mark Spencer: The Government are supporting Ukraine, the breadbasket of Europe, to export grain to countries most in need, including contributing £5 million to President Zelensky’s Grain from Ukraine initiative. The Government are also focused on the long-term drivers of global food insecurity, including climate change and biodiversity loss. We are supporting international programmes to improve the sustainability and resilience of global food systems.

Edward Leigh: The best form of food security is to grow more of our own food. Lincolnshire is the breadbasket of England, so it makes no sense that there are planning proposals to cover 10,000 acres of my constituency of Gainsborough with solar panels. We are all in favour of solar panels, but there are millions of acres of flat warehouse roofs they could go on. Will the Minister change the planning guidelines so that there is a presumption against building solar panels on 3b as well as 3a land? In reality, there is no difference in growing good wheat and barley between 3a and 3b land.

Mark Spencer: My right hon. Friend will be aware that the Department for Levelling Up, Housing and Communities is responsible for planning. The best and most versatile land is defined as land in grades 1, 2 and 3a of the agricultural land classification, and the national planning policy framework sets out that local planning authorities should consider all the benefits of the best  and most versatile land when making plans and decisions on development proposals. Where significant development of agricultural land is shown to be necessary, they should seek to use poorer-quality land in preference to higher-quality land.

Dan Jarvis: Could the Minister give an update on progress with tackling avian influenza?

Mark Spencer: Of course. We continue to work closely with the Animal and Plant Health Agency and Government Veterinary Services to monitor this. We are working with the sector to make sure we have the best biosecurity available. There has been a fantastic response from the sector to improve its biosecurity, but we continue to face the challenge of avian influenza. The long-term solution to the challenge is a vaccine, which is not currently available, but we will give all the support we can to the scientific sector to try to develop such a vaccine.

Animal Welfare (Kept Animals) Bill

Christine Jardine: What discussions she has had with the Leader of the House on the parliamentary timetable for the Animal Welfare (Kept Animals) Bill.

Therese Coffey: The Bill contains a variety of manifesto commitments that we are committed to progressing when parliamentary time allows, but the Leader of the House will continue to announce business in the usual way.

Christine Jardine: The 2021 commitment to tackle puppy smuggling via the Animal Welfare (Kept Animals) Bill was welcomed by a number of my constituents, but many of them are now concerned, because the secondary legislation being considered under the frozen Bill includes provisions to restrict the movement of heavily pregnant dogs, young puppies and dogs with cropped ears, and the level of puppy smuggling continues to rise. Can the Secretary of State provide assurances that the Government will continue to work towards ending this horrible practice and the movement of these poor animals across the border?

Therese Coffey: Yes, I can give the hon. Lady that assurance. It is our intention to deliver the manifesto commitments, and we are doing that in a number of different ways and have provided legislation to support a number of those commitments through private Members’ Bills. But as I say, the Leader of the House will continue to be responsible for announcing how the business of Government Bills will progress.

Desmond Swayne: For years, we have told people that we could not do anything about the cruelty of live export. The Secretary of State will understand those people’s frustration now that it is in our gift and in the Bill, won’t she?

Therese Coffey: Indeed. That is why it was a commitment in our manifesto: it is a freedom that we will be able to deploy having left the European Union. I am conscious that people are very interested in the progress of the Bill, but I stand by my earlier answer.

Peatlands

Wera Hobhouse: What steps the Government is taking to help restore peatlands.

Trudy Harrison: We are increasing levels of peatland restoration through our nature for climate fund, in order to restore approximately 35,000 hectares of peatland by 2025. To date, we have committed £33 million to restore 20,000 hectares of peatlands, with a further bidding round in 2023.

Wera Hobhouse: I thank the Minister for that answer. Well-maintained peatlands are a crucial nature resource in fighting the climate crisis. The Somerset levels near Bath contain 231 square miles of peatland, storing nearly 11 million tonnes of carbon, but 80% of the UK’s peatland is so degraded that it is acting as a net source of greenhouse gas emissions, doing the opposite of what it is meant to do. The Royal Society for the Protection of Birds says that part of the problem is the lack of available contractors with the necessary skills and capacity to allow for rapid restoration work. What is the Secretary of State, or the Minister, doing to increase the number of contractors?

Trudy Harrison: We have set out in our peatland action plan the measures that we will be taking. The hon. Lady is absolutely right to recognise the value that England’s peatlands provide: they are our largest terrestrial carbon store, and also provide homes for rare wildlife, regulate our water supply and provide a record of the past, all of which are incredibly important. In the net zero strategy, we committed to restore approximately 280,000 hectares of peatland in England by 2050.

Single-use Plastic

Alistair Carmichael: What recent assessment her Department has made of the feasibility of ending the use of non-essential single-use plastics.

Lindsay Hoyle: Who wants this one?

Rebecca Pow: Apologies, Mr Speaker; I was told that the right hon. Gentleman had withdrawn his question.
We have banned single-use plastic straws, cotton buds and stirrers, and have recently announced that additional items will be banned from October 2023, including plastic plates and cutlery and polystyrene food and beverage containers. Through our 25-year environment plan, we are committed to an ambition to eliminate all avoidable plastic waste by 2042.

Alistair Carmichael: The Minister has a long-standing record in this area; I thought she might be jumping to get to the Dispatch Box to answer my question. We have to accept, though, that although we were making very good progress on reducing and eliminating the use of single-use plastics before covid, the measures that were necessary during lockdown did see a lot of that progress reversed, and there is now a need for a renewed and reinvigorated approach. Unfortunately, in Scotland we  have a rather poorly designed deposit return scheme that risks further damage to the cause of reducing single-use plastics, so will the Minister join me and other Members across the House in designing a strategy for the eventual elimination of single-use plastics that can enjoy everyone’s support?

Rebecca Pow: As the right hon. Gentleman knows, I am always very keen to talk about these issues. Frankly, I believe this Government are doing a really great job in setting the direction of travel for reducing our use of plastics and, indeed, pressing on with all of our schemes—not just the individual bans that I have outlined—as well as the extended producer responsibility scheme, the data reporting section of which has already started; the deposit return scheme; and our consistent collections. I am sorry to hear what the right hon. Gentleman says about the Scottish deposit return scheme, but certainly, we in this place are pressing on with all our commitments and targets to eliminate all avoidable plastic waste.

Plastic Pollution

Fleur Anderson: What recent steps she is taking to help tackle plastic pollution.

Rebecca Pow: I thank the hon. Lady for her question. On a similar note to my answer to the previous question, the resources and waste strategy sets out our plans to eliminate all avoidable plastic waste by 2042. To do that, we have introduced a range of bans on certain plastic items, as she will know, and the extended producer responsibility scheme, for which data gathering has already started. The deposit return scheme and consistent recycling will also come on board.

Fleur Anderson: There is huge support for banning plastic in wet wipes from hon. Members on both sides of the House, retailers, producers and water companies. The Government’s consultation on the issue ended more than a year ago, but it was not included in the recent plastic announcements—the Government’s action on the issue is so slow. Will the Minister support the campaign of Water UK and the water companies to bin the wipe? Will she meet me to talk about when the Government will finally bring in that ban on plastic in wet wipes?

Rebecca Pow: I know how passionately the hon. Lady feels about the issue—I do too—but we have to get it right. We are still analysing the responses to that call for evidence. Great care has to be taken when considering something flushable, even if it does not have plastic in it—where does it go, where does it end up and what happens to it?—so we have asked for extra information about that. It is critical for wipes to be flushable, but I urge people not to flush things down the loo, because that is how we get blockages and fatbergs. I recently went to a nursery where they were making homemade wet wipes out of kitchen roll, none of which went down the loo. If hon. Members want to see my video on that, they should go on to my Instagram.

Environmental Land Management Schemes

Greg Smith: What steps  her Department is taking to support farmers through environmental land management schemes.

Mark Spencer: We published an update on our environmental land management schemes on 26 January. We have worked to ensure that there is something for everyone; we are expanding the sustainable farming incentive offer and launching a new round of the landscape recovery scheme this year. We will expand and enhance our popular countryside stewardship scheme later.

Greg Smith: I am grateful to my right hon. Friend for that answer. The £168 million farming investment fund, the six new standards in the SFI and the ELMS prospectus are good news and good progress, but I know from the National Farmers Union conference this week and from conversations with the Buckinghamshire committee of the Country Land and Business Association that detail is still missing that would give farmers the long-term certainty they need. I urge him to get the full detail of the schemes on the table as soon as possible.

Mark Spencer: We will continue to publish more information on our environmental land management schemes this year. That includes further details by the summer on the new actions that will be made available through the sustainable farming incentive and the countryside stewardship scheme.

Barry Sheerman: I am not usually a fan of Jeremy Clarkson, but I have been absolutely addicted to his television programme and the ventures of Diddly Squat farm. Does the Minister agree that that programme gives people a real insight into the bureaucracy and complications of the schemes? It is very complicated for farmers who want to earn a living and feed the nation. Will he visit Clarkson’s farm to give him a bit of support?

Mark Spencer: I join the hon. Gentleman in paying tribute to Mr Clarkson and what he is doing to advertise what is happening in the agricultural sector and some of the challenges it faces. The hon. Gentleman should bear in mind that the series was filmed before we announced lots of the detail about our ELM schemes, so some of the criticisms that are levelled at the Department have now been resolved and that information is out there. Mr Clarkson is, however, communicating with a different generation about the challenges of food production.

Food Insecurity

Rachael Maskell: What steps she is taking with Cabinet colleagues to tackle food insecurity.

Chris Elmore: What recent assessment she has made of the adequacy of UK food security.

Therese Coffey: The Department for Environment, Food and Rural Affairs leads on food supply and we are working closely with the Cabinet Office to ensure that food supply is fully incorporated into emergency preparedness. The UK has a highly resilient food supply chain that is well equipped to deal with situations with a potential to cause disruption. Our high degree of food security is built on supply from diverse sources, strong domestic production and imports  through stable trade routes. DEFRA has a collaborative relationship with industry, which allows us to effectively respond to disruption, should it occur.

Rachael Maskell: With the Office for National Statistics highlighting a 16.8% increase in food prices in the year to January, the Government have built their food poverty infrastructure on dependency on voluntary donations and retail waste donations. However, due to demand, food banks in York are running out and are eking out their food supplies. For my part, I am holding a city-wide donation day so that those who can give do so and those who are in need receive. We call it York Together, as we support one another. What are the Government doing to ensure that no one goes without?

Therese Coffey: The hon. Lady is right to praise the initiative with her constituents in York. That is very welcome, and it is an element of what can be done locally. We have talked about aspects of food pricing, and there is no doubt that inflation is really tough at the moment, but I am conscious that we still have a situation in which, generally across Europe, we have one of the lowest proportions of incomes being spent on food. Supermarkets have been very competitive, and we may discuss some of that later. I encourage her to also support of the household support fund, which is intended to go to people who are particularly in need. However, we know that one of the best ways for people to boost their income is not only to get into work if they are not in work already, but to work more hours or get upskilled to get a higher income. The local welfare grant, which was given some time ago by central Government to local councils, is there for them to use as well.

Chris Elmore: In the Secretary of State’s first answer, she talked about domestic security and domestic growing, but it is being made clear across broadcast media this morning that the UK Government have refused to give support to greenhouse growers across the winter season, which has added to the shortages we are seeing and the restrictions in supermarkets. Why are the Government refusing to help those farmers, and to ensure that we have domestic food security and do not have these shortages across the supermarkets?

Therese Coffey: The hon. Gentleman raises an important point. At this time of the year, we normally import about 90% to 95% of our food, because we cannot grow it in our soils, although I appreciate that there are industrial greenhouses that could grow some of these materials. We do know that energy prices have been going up, and the Government have been supporting businesses. It is when the change happens in April that I understand there may be an impact on greenhouses, which is why we will continue to work with the industry. However, we have always been a significant importer, particularly of things like tomatoes, recognising that farmers will choose to use the land in the way that they think is best to have a sustainable farming business in the UK.

Lindsay Hoyle: I call Scott Benton—not here.

Topical Questions

Laurence Robertson: If she will make a statement on her departmental responsibilities.

Therese Coffey: I am aware that many Members will be concerned by the reports about the availability of various horticultural products right now. As my right hon. Friend the Minister for Food, Farming and Fisheries said earlier, DEFRA is working closely with the industry to understand the issues with that supply chain, in which there was a particular issue in Spain and north Africa before Christmas and shortly after. Officials are already working with food retailers, and I think the Minister will be meeting them very early next week specifically to talk through certain aspects for supermarkets.

Laurence Robertson: In mid-March, the greatest National Hunt festival will take place at Cheltenham racecourse in my constituency. It is a sport that only this week the Prime Minister hailed as a showcase for global Britain. However, to maintain this world-leading position, the international movement of top thoroughbreds to this country is essential, so what have the Government been able to do to facilitate it?

Therese Coffey: I look forward to visiting my hon. Friend’s constituency on 17 March, where I will enjoy some of the racing. It is important that we have high standards of health and welfare for thoroughbreds. The Government are close to publishing our target operating model proposals, which will take a proportionate, risk-based and technically advanced approach to future sanitary and phytosanitary controls. We are still considering the approach specifically for live animals, particularly high-level equines, to understand how protecting biosecurity and minimising trade burdens can be carefully and safely managed.

Lindsay Hoyle: I call the shadow Minister.

Ruth Jones: Indoor air pollution is an increasing problem that poses health risks, but the Tories have no plan to tackle it. But do not worry, Mr Speaker, because help is on the way. Labour will have a standalone clean air Act in our very first King’s Speech. Before we get there, will the Secretary of State share what specific action she has taken to tackle indoor air pollution? What discussions has she had with other Departments, and what other actions will she bring forward in the coming months? In other words, where is the plan?

Therese Coffey: The clean air strategy of 2019 specifically identified indoor air pollution. Ongoing ventilation, and advice on that, is the standard approach. That is true of things such as scented candles and cleaning products. Although the chemicals are changing, a lot of the chief medical officer’s fairly recent report is already contained in the strategy. It is important that we tackle air pollution in all sorts of ways, but the best advice to improve indoor air quality is to keep windows open for five to 10 minutes a day to allow fresh air in. That will significantly help to reduce some of the impacts, and that is needed.

Mark Menzies: I thank Ministers for their continued support on coastal flooding, including the £10 million allocated to upgrade flood defences in Fylde, which is a low-lying, largely flat coastal peninsula, meaning that even inland areas remain  vulnerable to flooding. The Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Taunton Deane (Rebecca Pow), visited Fylde and saw that for herself, but will she join me for a further visit to the affected areas, and commit to producing a long-term plan to relieve the issues?

Rebecca Pow: I very much enjoyed my educational visit to Fylde to understand the benefits of our flood spending. Even in low-lying areas, there are benefits of protecting the businesses, which felt safer. Tourism and active travel on the great embankment had been strengthened. I would be delighted to come back if my diary permits it to see the further work that is being done to get even more out of the funding that the Government have committed to from our £5.2-billion budget.

Wendy Chamberlain: The hon. Member for Ogmore (Chris Elmore) mentioned the lack of Government support for greenhouse producers. Energy costs are having a great impact on farmers, but they are not included in the new business scheme coming into place at the end of March. Given that we are about to have an urgent question on food shortages, will the Government reconsider that decision?

Therese Coffey: The UK Government have already been helping households and businesses with the significant rises in energy costs. We are now starting to see a reduction in wholesale gas prices, and the Government are confident that that will start to feed through to electricity prices. We will remain focused on energy-intensive sectors that need ongoing support, but the scheme is much more restricted, and the hon. Lady will be aware of the reasons why.

David Duguid: What steps is my right hon. Friend taking to ensure that the fishing industry is not squeezed out of its livelihood by generally welcome but often conflicting factors such as offshore wind and marine protected areas? How will he ensure that the industry is adequately represented in the decision-making process?

Mark Spencer: I pay tribute to my hon. Friend’s work in that sector and the representations that he has made. I meet Scottish fishermen on a regular basis, and I am aware of the challenges they face due to spatial squeeze. I am also very much aware of the great work they do to keep the country fed with high-quality fish in our food markets.

Kate Osborne: Jarrow constituents face a rise in water bills from Northumbrian Water—a company owned by Cayman Islands-registered Hong Kong CK Hutchison Holdings. It underspent its budget for repairs by 48%, yet took profits of £2 billion a year, awarded millions to shareholders and pumped sewage into north-east waterways. Will the Secretary of State commit to fining water companies up to £250 million for dumping sewage?

Therese Coffey: Northumbrian Water is also the parent company of the water company that services my constituency. I am conscious that dividends were not  paid out during covid, but the point stands that we need improved environmental performance from water companies. We are doing that, and it is why we have given Ofwat powers, which they have been consulted on, to link dividend payments to things such as environmental performance. I hope that Ofwat will come forward with final proposals shortly.

Desmond Swayne: If habitats can be restored to a quality in which reptiles—in particular the smooth snake—can thrive, that will be good for all wildlife. That would be a good target, would it not?

Trudy Harrison: I absolutely agree on the importance of securing the habitats and the survival of reptiles. Indeed, we will halt the decline in species abundance by 2030, and increase abundance by at least 10% to exceed 2022 levels by 2042. That is all set out in our environmental plan—all 262 pages of it. On my right hon. Friend’s specific point, I very much look forward to an enlightening conversation with him.

Rachael Maskell: Child hunger has a significant impact on a child’s ability to concentrate, as well as on their behaviour and attainment. Labour has set out that it will provide breakfasts for children in school, and where Labour is in power it is providing lunches as well. What discussions is the Secretary of State having with the Education Secretary to ensure that children do not go hungry?

Therese Coffey: This is similar to the question the hon. Lady raised earlier. The Department for Education has responsibility for free school meals, and many millions of children benefit from them in this country. I am conscious that we want to ensure that food is affordable. Food price inflation is very challenging right now, and that is why we have acted to help with aspects of food production. We continue to try to ensure that we get through this challenging time. That is why there is support through things such as the household support fund, as well as other opportunities, to make sure that no child needs to go hungry.

Greg Smith: It was a pleasure to welcome the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Taunton Deane (Rebecca Pow) to Manor Farm in Chearsley last month, to see how farmer Rose Dale, the River Thame Conservation Trust and the Freshwater Habitats Trust have created new floodplain freshwater wetland habitats. Will she congratulate everyone involved in this hugely successful project? What steps are being taken to create further such wetlands?

Rebecca Pow: It was the most enjoyable and informative visit that I took part in with my hon. Friend; I ask that he pass on my thanks to Farmer Rose. The visit demonstrated the value of bringing water into the landscape; it has value for habitats and, in many other places, for flood control. Such nature-based solutions are one of the key planks of not just our flood policy but our habitat restoration project.

Chris Elmore: The Farm Safety Foundation—or Yellow Wellies, as most of us know it—has just completed a campaign to improve farmers’ mental health. Will the Minister set out what actions are being taken across Government, and at a devolved level, to develop mental health support schemes for farmers? According to the Yellow Wellies survey, farmers’ mental health is plummeting. We need a UK-wide strategy to offer more support.

Mark Spencer: I thank the hon. Gentleman for drawing attention to the campaign. The Yellow Wellies campaign had an action week last week; I hope he saw my contribution to that. It is very important that we recognise that mental health is a challenge in rural communities. If someone is working alone for many hours, it can lead to dark thoughts. We continue to work with charities in the sector to address the challenges those people face and to give them the support they deserve.

Christopher Chope: Why is the deposit return scheme in England not going to include glass bottles, unlike the one in Scotland?

Rebecca Pow: As my hon. Friend points out, two different schemes are proposed. We have consulted widely, in particular with industry, and that is why we have taken the decision not to include glass bottles. Glass bottles will remain in the consistent collections from the doorstep. From our consultation and stakeholder engagement, that is considered to be the best way to increase the amount of glass we recycle.

Simon Lightwood: The Government’s 25-year environment plan aims to deliver cleaner water for our communities. However, recent statistics show that the River Calder and the River Aire, which run through the Wakefield district, are the second and third most polluted waterways in England. The Office for Environmental Protection, the Government’s own regulator, has said that progress has fallen far short. After 13 years in power, what steps is the Secretary of State taking to clean up the waterways for the people of Wakefield?

Therese Coffey: We are picking up after the inaction of the previous Labour Government—that takes time. That is why we will continue to do the work. I say to the hon. Gentleman that it is important that we work on a catchment-based approach, which is the approach that is being taken. It is important that we focus in on those rivers, which is why I am asking Natural England to make progress with assessments of sites of special scientific interest around the country, thinking particularly of rivers. It is important that we continue to work together with the people who have the rights and responsibilities of owning those waterways at a local level to make sure that the hon. Gentleman’s rivers are cleaner than ever before.

Patrick Grady: Is the ploughing under of perfectly good crops because there is not enough labour to harvest them efficiently a success of Brexit?

Mark Spencer: The hon. Gentleman will be aware that we have increased by another 15,000 the number of visas available through the seasonal agriculture workers  scheme. An extra 10,000 visas are available should the industry require them. We are supplying the industry with the labour it requires, and the scheme seems to be working very well at this moment in time.

Allan Dorans: Polling commissioned by the Dogs Trust found that the biggest worry of almost a quarter of dog owners is the rising cost of dog food, causing deep concern and issues of abandonment. My hon. Friend the Member for Glasgow East (David Linden) raised at the previous DEFRA questions the campaign to remove VAT from pet food. What discussions has the Secretary of State had with the Treasury, and will the coming Budget introduce measures to reduce or remove VAT from dog food?

Therese Coffey: Pets are, of course, very precious to people and, after children, are often their No. 1 priority. It is important to try to make sure that people are generous. I make a plea to dog and cat food manufacturers to help their customers at this challenging time. The Budget will take place soon, but I want to manage expectations. I do not expect changes to VAT rates for specific products, but let us do what we can to make sure that our pets get fed.

Margaret Ferrier: Given the Secretary of State’s view that the financial sector must invest in projects to prevent biodiversity loss, what steps are the Government taking to incentivise businesses to play their part?

Trudy Harrison: We are working across Government, including with the Treasury, to identify opportunities for green finance. We absolutely recognise that in this country, but also all around the world, nature-based solutions and reducing the harm caused by public subsidies are a priority, as set out at COP15 in Montreal by my right hon. Friend the Secretary of State.

Lindsay Hoyle: I call Jim Shannon. [Interruption.]

Jim Shannon: I am sorry, Mr Speaker. I am so used to jumping up and sitting down, I did not realise that I had been called!
Northern Ireland fishermen have received only £14 million of the additional quota of £20 million that they were due to receive. In addition, the Northern Ireland protocol poses a potentially catastrophic threat to the fishing industry. What discussions have Ministers had with the Northern Ireland Assembly and the producer organisations about the future of fish stocks in and around Northern Ireland and the Irish sea?

Mark Spencer: Of course, we have regular meetings with the devolved Administrations. We also meet the Centre for Environment, Fisheries and Aquaculture Science regularly to discuss the level of fish stocks in the sea. We want to give out those quotas in a fair and equitable way that supports the whole of the United Kingdom and all four Administrations, and we will continue to have those conversations and discussions.

Alex Cunningham: I am really sorry to hear that Ministers are not prepared to travel to Teesside to face local people who are concerned about  ongoing sealife deaths. Ministers say that they want to find out the cause, so will they invest in further testing now rather than stick their heads in the sand?

Mark Spencer: The hon. Gentleman will have read the scientific report that says quite specifically that further investigation is highly likely to be futile and that we are quite unlikely to find that pathogen. I can say directly that if we were to analyse all the infections within the hon. Gentleman, we would find a lot of viruses that may not be relevant to his health or condition. That is the challenge. We have to find the pathogen at the moment that it is impacting on those crabs, but that moment has passed.

Alex Cunningham: I thought all medical records were private!

Lindsay Hoyle: Order. I call Barry Sheerman.

Barry Sheerman: Are you aware, Mr Speaker, that Shannon and Sheerman are going on a world tour shortly?
Many of us think that the tyres on our vehicles are made wholly of rubber, but research that I have come across recently shows that that is not true. There is rubber but there are also 72 chemicals, many of which have a link to cancer. That waste goes on our roads and flows into the gutters and into our streams and rivers and the sea. What are we going to do about this ghastly poison?

Therese Coffey: That is why we have increasingly high environmental standards, considering the different chemicals that are used in products every day. We have some challenges with the recycling of certain products, such as sofas and chairs. These are ongoing issues. I am not aware of the science that the hon. Gentleman has commissioned, but I am aware of how the Government have stepped up and supported companies such as Michelin with the circular economy. We made sure that it kept its factory here so that we could have retreading and remanufacturing. It is with that sort of approach—making sure that we really promote the circular economy—that we can try to tackle some of the issues that arise from plastics.

UK Food Shortages

Jim McMahon: (Urgent Question): To ask the Secretary of State for Environment, Food and Rural Affairs if she will make a statement on UK food shortages.

Therese Coffey: The United Kingdom has a highly resilient food supply chain, as demonstrated throughout the covid-19 response, and is well equipped to deal with situations with the potential to cause disruption.
In the last few days, we have seen Asda, Morrisons, Aldi and Tesco apply item limits to a small number of fruits and vegetables in response to issues with supply from Spain and north Africa caused predominantly by seasonal weather hampering production and harvest during December and January. The nature of horticulture and the effect on production of short-term events such as weather can create some volatility, and any growing forecast is subject to short-term alterations. We know that Ireland and other parts of Europe are facing very similar supply issues.
Industry has the capability, levers and expertise to respond to disruption and, where necessary, my Department will further support and enable that. I wish to reiterate that UK food security remains resilient, and we continue to expect industry to be able to mitigate supply problems through alternative sourcing options.
In 2021, we imported over £1.5 billion-worth of fruits and vegetables from Spain and £340 million-worth from Morocco. We consistently import over 30,000 tonnes of fresh tomatoes every month of the year. Through the winter months, the majority of imports are from Morocco and Spain, but in the summer months, as more production comes online, we also import from the Netherlands. In 2021, our home production accounted for around 17% of tomatoes.
We are working closely with industry bodies across the horticulture sectors to better understand the impacts. Officials have already met retailers, and there will be further meetings to understand their plans to mitigate current pressures. The Minister for Food, Farming and Fisheries will be convening a roundtable of retailers to explore with them their contractual models, their plans for a return to normal supplies, and contingencies for dealing with these supply chain problems.
We know that farmers and growers around the world have been facing significant pressures caused by the invasion of Ukraine and the historic outbreak of avian influenza in Europe. We also recognise the impact of rising food prices as a result of global shocks including the spike in oil and gas prices, exacerbated by the conflict in Ukraine. That is why the Government have taken steps to offer support with energy costs. We cut tariffs to reduce feed costs, we improved avian influenza compensation schemes, and we have taken a range of measures on fertilisers. Indeed, UK growers were able to access the energy bill relief scheme.
The Department for Environment, Food and Rural Affairs will continue to keep the market under review through the UK agriculture market monitoring group and other engagement forums.

Lindsay Hoyle: I call the shadow Secretary of State.

Jim McMahon: Thank you, Mr Speaker, for granting this urgent question. You will have seen coverage of this issue all over the front pages of the papers and all over the TV, because there is genuine public concern about the availability of food. Given her responsibility for our food security—let us bear in mind that food security is national security—this is mission critical for the Secretary of State. Frankly, I found her response to be completely detached from the reality being faced on the ground, whether in our supermarkets or by our farmers.
There is this idea that, somehow, the issue is all down to external forces. Of course, we understand the impact of covid and the spike coming out of that, we understand the impact of Brexit, we understand the impact of Ukraine and we understand the impact of energy prices. We understand all that. The question is, what is in the Government’s control? What levers do they have to make the situation better today? They did not have to make changes to direct payments that undercut farmers. They did not have to agree to international trade deals that undersell UK farmers. They could have made sure that farmers and food producers had access to the energy-intensive support scheme, but they decided not to do that. They could have made sure that the labour quotas were sufficient to ensure that food was not rotting in the fields. All those levers were available to the Government.
When I met Lancashire farmers who had fallen victim to avian flu and were struggling to find ways of recovering and rebuilding their businesses, they told me that there was not a single DEFRA scheme to help them restart. There are 1 billion fewer eggs on our shelves this year than there were before the pandemic. On pancake day earlier this week, people could not buy eggs to make their pancakes.
This is the result of the Government’s indifference and dithering. If they do not understand that food security is national security, and that we need to end sticking-plaster politics and have a long-term plan, there is no hope for the nation.

Therese Coffey: I think I set out pretty clearly what is going on right now. [Hon. Members: “Nothing is going on!”] It sounds to me as if the shadow Secretary of State has abandoned the agricultural transition plan, which conflicts with what the Leader of the Opposition said the other day. That is interesting: we are seeing a Labour split already, within 48 hours. I am slightly surprised that the hon. Gentleman is trying to play politics with such a serious situation.
The House should bear in mind some of the support that has been provided, such as the changes that we made to the avian influenza compensation scheme. It is true that the number of hens fell by about 4 million last year, but there are still between 36 million and 38 million laying hens in this country. It is important that we continue to have that discussion.
The retailers have had a pretty reliable supply chain, but what has happened in southern Spain and Morocco is unusual, which is why we need a resilient farming industry and a resilient supply chain. [Interruption.] I hear someone mention greenhouses. We are seeing the industry evolve, but I am not aware that any greenhouse owner benefits from any basic payment scheme. The energy  bill relief scheme continues to be available to various parts of the sector, although I am aware that that will not necessarily be the case from April onwards, and that there may be a significant reduction.
I think the hon. Gentleman needs to be careful when it comes to the question of ensuring that we retain confidence in the food supply chain. Supermarkets have decided to stop a lot of the buying so that everyone still has access to enough fruit and vegetables. I am led to believe by my officials, following discussions with the industry and with retailers, that this situation will last for another two to four weeks. We must try to ensure that there are alternative sourcing options, which is why the Department has had those discussions with retailers, and there will be further discussions led by Ministers so that we can try to get over this and to avoid similar situations in the future. Even if we cannot control the weather, we can and must try to ensure that the supply is not frustrated in quite the way it has been owing to these unusual weather incidents.

Desmond Swayne: If only I had been told before I voted for Brexit that it was going to cause frosts in Morocco, I could have made a different decision—couldn’t I?

Therese Coffey: One of the joys of being the Secretary of State for this Department is having the environment and agriculture in the same portfolio, which leads us to take a sensible, careful, long-term approach to considering the factors that can help both our farming sector and the environment. We took that approach when designing the environmental land management schemes, and we are now on a careful journey as we move people away from a very rigid element of what was the basic payment scheme under the common agricultural policy, when more than half the subsidy went to just 10% of the farmers in this country. [Interruption.]
The hon. Member for Cambridge (Daniel Zeichner) wanted to go back into the European Union, I believe. That decision was made by all the EU countries, so he clearly does not know his history or know anything about the CAP. What he should be doing—unlike the shadow Secretary of State, who now seems to be undermining the environmental land management schemes—is recognising some of the initiatives we have been funding, the various grants we have provided, and the way in which we have tackled, for instance, tariffs on imports. It is by adopting approaches of that sort that we can help our farming industry.
Importantly, the retailers are working to provide alternative sourcing so that those restrictions on consumer consumption will not be in place for much longer.

Lindsay Hoyle: I call the SNP spokesperson.

Patricia Gibson: The Secretary of State’s response shows that she and her Government refuse to take any responsibility for their own shortcomings. Farmers across the UK have been warning of the risk of food shortages for some time as a result of rising costs and Brexit trade barriers. Why did the Government not heed those warnings? Who would have thought that, in 2023, the UK would be facing the problem of food shortages which, despite what we have been told, is uniquely affecting the UK?  We are the only European country with empty supermarket shelves. The reality is that food shortages are due to low food production, which is in serious decline under this Government’s watch.
In addition, the supermarket sector has been “hurt horribly” by Brexit, according to the chief executive of Sainsbury’s. The chair of Save British Food has accused the Government of “absolute negligence”, of not caring about food production and of shattering food security. In all honesty, is the Secretary of State not embarrassed and ashamed that, under her and her Government’s watch, the UK is poorer, has less food, and has a declining agricultural sector and higher food costs because of Brexit failure and the empty rhetoric of taking back control?

Therese Coffey: I do not recognise a lot of what the hon. Lady said about food production. It might be true in Scotland, but that is a devolved matter—she might want to take a look. [Interruption.] The hon. Lady does not seem to take any ownership of what the SNP Government are doing in relation to farming policies. As we set out in the Government’s food strategy last year and in our manifesto, we want to maintain, if not increase, our domestic food security, which is what I said to the NFU yesterday. However, as she will know, there are a number of products that we cannot grow in this country and we also have a season. One of the main differences between our supermarkets and those in Europe is that our supermarkets often have a fixed price contract. In other countries, there is often a trend towards variable price contracts. We recognise that and will be going into that in detail with the supermarkets.
As I have said, there has been unusual weather in Morocco and south Spain, which has led to a temporary restriction—[Interruption.] The hon. Member for North Ayrshire and Arran (Patricia Gibson) continues to chunter from a sedentary position. As I have said, it is for her and her Government in Scotland to decide what they are doing about food production. This Conservative Government back our farmers. We want them to grow food—that is the main purpose of farmers—and to make a good living out of it, and we will continue to support them in that. The £2.4 billion a year will go towards a combination of basic payments and the initiatives to make sure that we have a resilient, sustainable and profitable food industry for many generations to come.

Selaine Saxby: Does my right hon. Friend agree that the supermarkets are still importing far too much produce for us and that we should be eating more seasonally and supporting our own British farmers. If we were to move to a seasonal way of eating, many of these problems would be avoided. Great food products are available from local farmers at this time. May I take the opportunity to thank the Ministers from the Department for Environment, Food and Rural Affairs for joining me yesterday at the Taste of Exmoor event where we met some of those farmers vital to our food supply.

Therese Coffey: As ever, my hon. Friend shows that she is a great champion for her constituents by bringing the Taste of Exmoor to Parliament. I do not know whether you had the opportunity to attend that event, Mr Speaker. I am afraid that I did not, because I was returning from the NFU conference. It is important to make sure that  we cherish our specialisms in this country. Many people would be eating turnips right now rather than thinking necessarily about lettuce, tomatoes and similar. However, I am conscious that consumers want a year-round choice, and that is what our supermarkets, food producers and growers around the world try to satisfy.

Clive Efford: I always knew that the Conservatives were a bunch of bean counters, but this is off the scale—our supermarkets have had to impose a form of food rationing, while the chief bean counter comes to the Dispatch Box and says, “Crisis? What crisis?” Does the Secretary of State agree with the president of the National Farmers’ Union, Minette Batters, who has accused the Government of a “dereliction of duty” for failing to ensure that we have a fit-for-purpose post-Brexit set of border checks on agricultural imports? That was not what we were promised before the Brexit vote?

Therese Coffey: I think the hon. Gentleman should withdraw the words and phrases he used, because I did not use those words at the Dispatch Box. We recognise this particular issue, right now, which is why the Department is already in discussion with retailers, and why the Minister will meet retailers. This incident is driven by aspects of the supply chain, and the primary source for goods right now is an area that was affected by very unusual weather before and after Christmas. To have snow, and the amount of heat that was there, and adverse weather, is pretty unusual and something that the supply chain has to try to manage. Right now supermarkets have chosen a particular way. That is why we will continue to meet them, and I am hoping that this will be a temporary issue. This volatility is unwelcome, but I am conscious that our supply chain is resilient and that we will continue to invest in our farmers for generations to come.

Greg Smith: The Secretary of State is absolutely right in pointing to the factors that she has in answering this urgent question. May I push her a little further on the question of energy, and urge her to work more closely with the Secretary of State for Energy Security and Net Zero to see whether we can reclassify what is energy intensive industry within our support schemes? Agriculture and horticulture are incredibly energy intensive, yet they have not had the same support as some manufacturing sectors. That could revolutionise British farming and keep businesses afloat.

Therese Coffey: I am conscious of what my hon. Friend says. Industrial glasshouses in particular are an emerging industry, not a long-established one, and my right hon. Friend the Secretary of State will always be looking to consider who should be eligible. We will continue to make the case for why we think this is an important sector. I am conscious that there is a significant scaling back, recognising other issues, such as the wholesale price of gas which has fallen, and we expect to see a reduction in energy prices coming through.

Jamie Stone: I am concerned that these food shortages will impact on school meals. Should we be looking to give free school meals to far more children in England, just as Scotland and Wales already do?

Therese Coffey: Free school meals is a policy for the Department for Education. I am conscious that due to the Barnett formula, the Administrations of Northern Ireland, Scotland and Wales get a lot more funding per head. I do not anticipate that will change, but those Administrations have the freedom to make policies that are relevant to their local demographics. We want more people to be in good profitable work so that they do not need to rely on free school meals, and that is the intention of the Government going forward.

Andrew Bridgen: Does my right hon. Friend agree that retailers have taken the right strategy to avoid panic buying? As we know from a couple of years ago, any perceived or real shortage leads to panic buying—we recall the situation with toilet rolls a couple of years ago. Fruit and vegetables are perishable and have a short shelf life, and panic buying would not only exacerbate the shortage but would lead to a lot of food waste.

Therese Coffey: The hon. Gentleman is knowledgeable in this area, and consumers must be able to buy the products they want to buy. Supermarkets normally have a very resilient supply chain, but we have a particular issue right now, which I believe they are trying to fix, and some supermarkets are taking that approach to ensure that every customer can access those products. It is important to reflect on the fact that sometimes words are said—before Christmas a particular industry person talked about a shortage of free-range turkeys; consumers heard, they moved their things, and we ended up with a glut and prices fell. People need to be careful when we are talking about the resilience of the food supply chain—we have that confidence. I know this is temporary—I believe it to be temporary—and I am confident it will be fixed within the next two to four weeks.

Kerry McCarthy: The Secretary of State will have heard the leader of the Labour party announce at the NFU conference this week that he wants 50% of all public food procurement to be locally and sustainably sourced, as France has done for a long time. DEFRA had a consultation on public sector food procurement that closed on 4 September, nearly six months ago. I have not heard any Minister mention it since. Is the consultation still live? When will we have a response? This will be hugely influential in supporting food sovereignty in this country.

Therese Coffey: We set out our commitment to British food in our food strategy and our manifesto. It is a welcome compliment that the Leader of the Opposition is following a Conservative Government policy. We will act on the response to the consultation, and the hon. Member for Bristol East (Kerry McCarthy) will be aware that we need careful consideration across Government of how to take certain policies forward. We also need to be mindful of things like World Trade Organisation rules, but I will continue to champion British produce and local procurement. The public sector can make those choices now if it wishes; it does not need Government clearance.

Christopher Chope: Does my right hon. Friend accept that 170,000 tonnes of fresh produce is wasted each year in this country? Does she think the current crisis will encourage consumers to value their fruit and veg, and their five a day, more highly?

Therese Coffey: It is very important that consumers have that choice, but we are also committed to trying to reduce the amount of food waste. It is a shame for any food to be wasted. We are also concerned about the carbon emissions that arise from food waste, and we are trying to reduce them on our pathway to net zero.

Amy Callaghan: Despite claims that this is a Europe-wide problem, there are no reported food shortages in France, Germany and other European net food importers. Is it not the case that this problem was created by inward-looking little England and this British Government?

Therese Coffey: No, it is not.

Luke Pollard: It is 2023, and there are crops rotting in the fields because there are not enough people to pick them, there are kids going hungry in all our communities and now we have rationing in our supermarkets, and it is not because people are stockpiling and panic buying salad, although a lettuce lasted longer than the last Prime Minister. I want the Secretary of State to have more grip, control and leadership on this issue. Her responses so far have been complacent. Unless she wants to go down as the Secretary of State for sewage, food shortages and rural poverty, what is her plan to properly address the food shortages we face? This is a serious issue for families across the country.

Therese Coffey: This is a serious issue, but I am afraid the hon. Gentleman’s question shows his lack of knowledge and his bandwagon jumping. He suggests that there is nobody picking vegetables in our fields, but that is not the case right now. We have a supply chain that brings in food from around the world. I would love to hear about the farms in his constituency that are short of people to pick tomatoes or lettuces. It is probably as rare as—[Hon. Members: “As what?”] I was about to say that it is as rare as his wanting us to be successful. [Interruption.] What is the best way to put it? It is as rare as gold at the end of a rainbow. Perhaps he believes in fairy tales. He certainly does not know how the food supply system works. He jumps on a bandwagon, and he must be embarrassed. I hope his constituents reflect on the fact that he knows nothing about how their daily lives are affected by this.

Barry Sheerman: I know the Secretary of State to be a decent, good-hearted woman, but I say to her that this is a national emergency. Lower-income children and families in my constituency are struggling to afford basic food such as eggs and milk—all the basics a family have to have. There is a national emergency; it is not just the shortages, but the high cost of basics. Will she take action?

Therese Coffey: This urgent question is about food shortages and I have set out pretty clearly to the House what has happened in the supply chain, what the Department is doing about it, what the sectors are doing about it and my expectation that this will be a two to four-week element.
The hon. Gentleman talks more broadly about food prices. This country has for a long time enjoyed the competitiveness provided by the supermarkets, but I am conscious of the fact that that has also had impacts on  some of the contracts that have been signed by farmers; a lot of them have involved fixed prices. However, it is important that we continue to support our domestic food production, which this Government clearly do. It is important that we continue to try to support people with the cost of living, which this Government are absolutely doing. It is important, as the Prime Minister set out in our top priorities, to be halving inflation. We are taking short, immediate approaches as well as longer-term approaches, such as getting energy security. Those are the ways not only to get sustainable inflation, but to act on the food strategy we set out last year. We will continue to make sure that farmers produce in this country and that there is no reason why people do not have food on their dinner plate every night.

Ben Lake: Declining self-sufficiency over the past 30 years has left the UK increasingly exposed to shocks to global supply chains. Brexit trade barriers hinder attempts at sourcing alternative supplies and the Government’s own food security report identified that climate change is likely to have a significant impact on production in the countries from which we import a lot of our fruit and veg at present. What are the Government going to do to support and incentivise greater domestic production to avoid a repeat of these shortages?

Therese Coffey: The UK Government have already set out their approach. We also have a strong trade agreement with the EU. I am very conscious that some of this is connected to a particular shortage of supplies that come into most of our supermarkets, in a part of Morocco and southern Spain. I am also aware that the hon. Gentleman represents a Welsh constituency and this is a devolved matter, so he might want to ask the Labour Government in Wales what they are doing to provide support.

Kirsten Oswald: The Secretary of State was booed this week by farmers at the NFU conference for talking down to them and claiming that she knew better about the cause of food shortages. She is telling us today that this is an EU-wide problem, but we can see that there are not the same shortages EU-wide, including in other European net food importers. Does she think that adverse weather really only affects the sunny uplands of Brexit Britain? Does she not see that her continuing to be wedded to the failure of Brexit is one reason why we are seeing less food, a poorer country overall and higher food costs?

Therese Coffey: No, that is not the situation. [Interruption.] The hon. Member for Paisley and Renfrewshire North (Gavin Newlands) could have been in the Chamber earlier if he wanted to ask a question. What we have particularly now is an issue that has affected a supply chain of certain products and the supermarkets are acting. It is happening in other European countries, although not in all of them. As I have explained to the House on more than one occasion, sometimes, the contracts are different, which is why my right hon. Friend the Minister for Food, Farming and Fisheries is convening a meeting with the retailers directly. We have already been doing that as a Department and we will continue to do so.

Wera Hobhouse: The Secretary of State keeps dismissing the concerns of the farming industry about food shortages, yet supermarkets are restricting  food to customers—clearly, her Department is out of touch with the real world. Does she agree that the Prime Minister should call a Cobra meeting because this is now a national emergency and out of the control of her Department?

Therese Coffey: As I said to the NFU yesterday, farmers are here to feed the country. That is why we support them and will continue to support them in a number of different ways. We are going through a transition away from a financial support system of direct payments, the basic payment, where more than half the money was going to just 10% of farmers because it was based on how much land people had. That is part of the journey we are on, but there are still significant amounts of basic payments going in. That is why we still want, as our manifesto set out and as I said to the NFU yesterday, to at least maintain the amount of domestic food production, if not increase it. We will continue to try to support that, to ensure that our farmers are there for generations to come.

Jim Shannon: I thank the Secretary of State for her answers and for trying to be constructive in those answers, as always. Having heard examples of shoppers turned away from shops for trying to purchase vegetables for their family of seven—I was told that story just yesterday—it is clear that steps must be taken to secure our produce. Can she outline the steps being taken to ensure that paperwork for importation is a smooth system, allowing new suppliers to be found and easily facilitated at this time of shortage and need?

Therese Coffey: I am conscious that, as the hon. Gentleman will be aware, we are still working on issues involving the Northern Ireland protocol in terms of exchanges between parts of the UK. It is important to recognise that suppliers are proactively working with supermarkets—that is what we have been told. We have been told there is an issue for potentially up to four weeks, and I am keen that the sector gets on with alternative sourcing options. Meanwhile, we will continue to encourage and boost food production. That has always been set out in our food strategy and our manifesto commitment, and I am determined we will try to deliver it.

Business of the House

Thangam Debbonaire: Will the Leader of the House give us the forthcoming business?

Penny Mordaunt: The business for the week commencing 27 February will include:
Monday 27 February—Second Reading of the Lifelong Learning (Higher Education Fee Limits) Bill.
Tuesday 28 February—Opposition day (13th allotted day). Debate in the name of the official Opposition. Subject to the announced.
Wednesday 1 March—Motion to approve an instruction relating to the Social Housing (Regulation) Bill [Lords], followed by remaining stages of the Social Housing (Regulation) Bill [Lords].
Thursday 2 March—General debate on changes of name by registered sex offenders, followed by general debate on Welsh affairs. The subjects for these debates were determined by the Backbench Business Committee.
Friday 3 March—Private Members’ Bills.
The provisional business for the week commencing 6 March includes:
Monday 6 March—Committee of the whole House and remaining stages of the Social Security (Additional Payments) (No.2) Bill, followed by consideration of Lords amendments to the Genetic Technology (Precision Breeding) Bill.
Tuesday 7 March—Consideration of Lords amendments to the Public Order Bill.
Wednesday 8 March—Estimates day. At 7pm the House will be asked to agree all outstanding estimates.
Thursday 9 March—Proceedings on the Supply and Appropriation (Anticipation And Adjustments) Bill, followed by business to be determined by the Backbench Business Committee.
Friday 10 March—The House will not be sitting.

Thangam Debbonaire: I thank the Leader of the House for the forthcoming business.
Tomorrow, we mark one year since Russia’s barbaric invasion of Ukraine. We reflect together on the immense suffering the Ukrainian people have endured, but also on their remarkable courage and resilience. President Zelensky, on his recent inspiring visit to Parliament, made it clearer than ever that Putin must be defeated in Ukraine, and we stand united as a country with him and with all Ukrainians.
Scrutinising legislation is what makes us MPs, and a confident, credible Government would accept that principle and provide MPs with the means to do so. Why, then, did the Government only publish an impact assessment for their sacking nurses Bill weeks after the Bill had been introduced and then forced through all its Commons stages? As well as being published late, its quality is poor; an independent watchdog has branded it “not fit for purpose” and the Government are clearly trying to hide the severe and disproportionate impacts that the law will have on small businesses. Is this why the Government chose to rattle that shoddy, unworkable Bill through Parliament? They are putting an intolerable burden on  employers, unions and workers, and what for? To sweeten some of their own Back Benchers. Has the Business Secretary at least read the impact assessment and the subsequent report, and will she publish proper assessments for any future regulations that the Government plan to introduce as a result of the Bill? Could the Leader of the House please ensure that any other assessments for further legislation are published on time, before the Bill? This simply is not good enough.
We have yet another Tory Prime Minister forcing the people of this country and the businesses and people of Northern Ireland to wait while he plucks up the courage to stand up to his own party. Let me tell the Leader of the House what ought already to be clear: this country is sick of waiting for weak Tory leaders to get on and govern. It seems that a deal has been done, but the Prime Minister is too scared to sign it off with his own Back Benchers. So let me repeat Labour’s offer on the Northern Ireland protocol revisions: if the deal stands the test of being in the national interest and in the interests of the people of Northern Ireland, we will put the country first and provide the support necessary to get it through Parliament. Will the Government put country before party and accept our offer?
Yesterday, the Prime Minister said that
“Parliament will express its view”—[Official Report, 22 February 2023; Vol. 728, c. 219.]
but his spokesperson then said that they would “not get into hypotheticals”. Could the Leader of the House clear up the confusion? Will this House get to vote: yes or no?
The Government must start using the time allocated for passing legislation properly. Week in, week out, I ask the Leader of the House whether she will reach down the back of the Government’s bulging sofa and find the legislation that they keep managing to lose. They complain about a lack of time, but they spend it on what amounts to nothing more than red meat for a noisy minority of their Back Benchers.
Take the Northern Ireland Protocol Bill, for example. That Bill means ripping up international agreements and breaking international law. That is not the way forward for a modern, outward-looking country, and it is never going to work; it will lead only to uncertainty and unnecessary confrontation with our EU friends and neighbours. Will the Government do what we have called for by scrapping the Northern Ireland Protocol Bill?
Whether they are in my Bristol West constituency, in Swindon, or elsewhere up and down the country, voters know that the Government have broken our country and have no plan to fix it. Labour does have a plan. Today, the Leader of the Opposition has set out Labour’s vision for a decade of national renewal: strong economic growth, clean energy, improving the NHS, reforming the justice system and raising education standards. That is the choice that voters have: five more years of Tory failure—on top of the last 13—or a fresh start with a Labour Government.

Penny Mordaunt: I join the hon. Lady in her comments about Ukraine. Tomorrow, we will mark one year since Russia’s illegal war began and, on Monday, we marked nine years since Russia’s illegal annexation of Crimea. In the minute’s silence tomorrow, I know that we will all think about those who have been lost, the huge suffering  and hardship that people are enduring, and, most of all, the courage and heroism of the Ukrainian people. I join her in thanking every Briton who is standing with them, who has taken them into their homes, and who is enduring hardship for their sake and for freedom’s sake. I thank in particular all Members of this House; we are all united in our support for Ukraine and that resolve will be unwavering.
The hon. Lady asks about impact assessments. I have been quite vocal about the importance of impact assessments not just to enable scrutiny but to make Ministers give good decisions. She again invites comparisons between the records of our parties. I note that Labour’s 11th relaunch in two years is going on as I speak. I could talk about the fact that the UK has had the strongest growth of any G7 country over the last two years; that we have halved crime with the same number of officers that Labour had; that we have got 4 million more people into work; that we have 10% more “good” or “outstanding” schools; that the Labour-run NHS Wales is outperformed fivefold by NHS England; or that we have had a fourfold increase in renewables since 2011, but that would be churlish of me.
The hon. Lady talks about the very serious situation with the negotiations, and of course, the people of Northern Ireland are at the forefront of our minds in that. I gently suggest to her that the Northern Ireland Protocol Bill is quite helpful in focusing minds to get the right result. If she really does want a deal, she should not just say she will support the Prime Minister but demonstrate support for him and for the objective that all Members of this House share, which is to alleviate the friction and to address the democratic deficit for the people of Northern Ireland. She and her party should try to stand up for the United Kingdom, as opposed to helping those on the other side of the negotiating table.
I welcome the hon. Lady saying that she will support a deal brought forward by the Prime Minister. As I have previously noted, Labour are very keen to be seen to support all sorts of Conservative policies. They are in favour of fiscal conservatism, “take back control” conservatism and small state, big society and local conservatism. But nobody is fooled by this reinvented Labour party, because what we are seeing is cosplay conservatism. They do not endorse strikes, but they will not condemn them either. They say they support striking workers, but they will not be photographed with them. They centralise and regionalise while talking about localism. They say they are not big spenders while racking up billions in unfunded plans. They say they will stand up for women while undermining and not supporting their own MPs.
The Leader of the Opposition used to promote the right hon. Member for Islington North (Jeremy Corbyn), and now he has cancelled him, along with every single one of the 10 leadership pledges he made when he succeeded him. The Leader of the Opposition is socialism’s sensitivity reader. He is editing out the twits and the Trots, but the British people will not be fooled—they will see through it—because it is not enough to say that socialism does not work; you have to believe it too.

Peter Bone: Wellingborough Walks is a delightful avenue of Victorian trees that stretches from the town to the River Nene, and there is a  tree preservation order. Unfortunately, at this moment, Bovis Homes—now Vistry Group—is attempting to cut those trees down. In fact, an 84-year-old constituent of mine has been arrested trying to stop it today. Vistry Group is doing it on the basis of an old planning permission that is unclear. I have called for a pause for a month, so that this can be sorted out. Vistry Group refuses to do that. Could the Leader of the House arrange a debate on the Floor of the House entitled “The reputational damage that actions by Bovis Homes/Vistry Group is doing”?

Penny Mordaunt: I thank my hon. Friend for raising that important point. We know that in these circumstances there are balances to be struck, but it is critical that there is the time and space to ensure that everyone is properly consulted, sometimes with alternatives brought forward. I am always keen to encourage Members to apply for debates, but in this instance, I really hope that the firm involved has heard what he said today and will pause, to allow a little more time to get a good result for the whole community.

Lindsay Hoyle: The SNP spokesperson today is Gavin Newlands.

Gavin Newlands: I pass on the apologies of my hon. Friend the Member for Edinburgh North and Leith (Deidre Brock), who is away on parliamentary business. Mr Speaker, you may have seen last night that the Home Secretary was interviewed by the only outlet she can bear scrutiny from: GB News, or GBeebies, as I call it. She said that the British are too “shy about our greatness”. For starters, I wish she would be a little shyer about her own greatness, but perhaps she has picked up that Britons are all too aware that our international stock has plummeted. As Burns might say to her,
“O wad some Power the giftie gie us
To see oursels as ithers see us!”
Perhaps we can debate Britain’s place in the world and just how much it has fallen.
The Leader of the House likes to bring up the subject of ferry procurement, which is bold, considering the antics of the right hon. Member for Epsom and Ewell (Chris Grayling) in awarding ferry contracts to companies without ferry boats—not too dissimilar, in fact, to awarding PPE contracts to mates who do not produce PPE. The Leader of the House is correct that the ferry situation is sub-optimal, but it is being investigated. I can only therefore assume that Westminster has an excellent record in capital and procurement—PPE aside, obviously—but it does not. Thameslink had a budget of £2.8 billion, cost £7.3 billion and was two years late. Crossrail had a budget of £14.8 billion, cost £19 billion and was four years late. The Jubilee line extension had a budget of £2.1 billion, cost £3.5 billion and was a year and a half late. Perhaps we can have a debate on capital projects and procurement, where we can discuss the Stonehenge bypass and Ajax tanks.
Finally, Mr Speaker, we need to debate what constitutes a democratic deficit. Yesterday, the Prime Minister said that
“addressing the democratic deficit is an essential part of the negotiations that remain ongoing with the European Union.”—[Official Report, 22 February 2023; Vol. 728, c. 221.]
Perhaps my memory is playing up, but I seem to recall that Northern Ireland voted to remain in the European Union; in fact, a clear two-to-one majority supports rejoining. There is 20% majority support for the protocol, and perhaps most condemning of all, just 3% of Northern Irish voters trust this Government to manage their interests on the protocol. In contrast, the people of Scotland have not voted Tory since the ’50s, voted overwhelmingly to remain in the EU, and voted time and again to be allowed to choose their own future. Now, that is a democratic deficit.

Penny Mordaunt: I am glad that the hon. Gentleman has been watching the news, especially GB News—I am very encouraged to hear that. I wonder whether that channel is covering Audit Scotland’s report on the SNP’s handling of the NHS, which is out today. Under those circumstances, I think it is brave of the hon. Gentleman to go on fiscal responsibility. He focused on Brexit, however, so let me address the points he raised.
This might be one of the last exchanges we have about Brexit, because it is going to be very hard for the SNP to come to this Chamber and raise the issue of Brexit ever again. Even the most outrageous claims about the supposed negative impacts of leaving the EU made by the most fanatical rejoiners cannot compare with the damage that will be done to the UK’s internal market, to producers and businesses in Scotland, and to the cost of living for the hon. Gentleman’s constituents by the SNP’s DRS—deposit return scheme. In a few months, the only way in which people will be able to buy Scottish produce—if it is contained in glass or plastic—is to come south of the border. Such items will be as rare in their land of origin as Labour MPs.
In all seriousness, I urge the SNP to listen to communities and producers in Scotland and to produce a smarter scheme. On this, as on all things, the SNP should be driven by what is in the Scottish people’s interest. The party’s leadership contest, which is going on at the moment, is an opportunity for a reset and a fresh start, and to end the slopey-shouldered separatism that has done such a great disservice to such a great nation. I suggest to all candidates in the SNP’s leadership contest that a much better DRS initiative would be to desist ruining Scotland.

Lindsay Hoyle: I call Andrew Bridgen.

Andrew Bridgen: Thank you, Mr Speaker—[Interruption.] When they have finished.
The World Health Organisation pandemic treaty is deeply concerning. It seeks to give the discredited WHO huge powers over this country and our people—powers to call pandemics, enforce lockdowns and vaccinations, and decide when any pandemic is over. Can we have an urgent debate on that proposed treaty, which, if passed, will take accountability, democracy and sovereignty from our constituents and hand them over to unelected and discredited bureaucrats? That would be the antithesis of Brexit itself.

Penny Mordaunt: I thank the hon. Gentleman for his question. That is an excellent topic for a debate, and I will certainly make his views known, both to the Department of Health and Social Care and to the Foreign, Commonwealth and Development Office, which looks after many of the international organisations involved.  As we know from the pandemic and from other outbreaks such as Ebola, such diseases know no borders. It is only through international co-operation and collaboration that we will arrive at solutions to ensure that we do not have a repeat of the last few years, and that everyone in the world is safe from those terrible diseases.

Lindsay Hoyle: I call the Chair of the Backbench Business Committee.

Ian Mearns: I am very grateful, Mr Speaker. I thank the Leader of the House for her business statement and for announcing the business. I inform Members that the closing date for estimates day debate applications is tomorrow at 1 pm, and—as the Leader of the House announced in her statement—those debates will be aired on Wednesday 8 March, before the House is asked to agree all outstanding estimates. We are still open to other Backbench Business debate applications for the Chamber and Westminster Hall; we welcome such applications.
The plight of children with special educational needs and their parents has long been known, and there is worsening evidence of rationing and queues for assessments; shortages of key staff, such as educational psychologists, to do those assessments; and education, health and care plans increasingly showing signs of being resource-led rather than led by the needs of the individual child, which leads to greater recourse to special educational needs tribunals. The Green Paper, which was overdue but welcome, was published 11 months ago. Can we have a statement on the Government’s intention to legislate on and properly fund provision for children with special educational needs, so that, as the Green Paper highlights, they get the
“right support, in the right place, and at the right time”.

Penny Mordaunt: I thank the hon. Gentleman for his announcement on Backbench Business debates. We are pleased to be able to give him time on 2 March and 9 March, and we encourage all hon. Members to make use of the Backbench Business Committee.
The hon. Gentleman is absolutely right to raise the important issue of special educational needs. It is critical to enable everyone to reach their full potential and ensure that people are not diagnosed late on in life, so that they can maximise their years in education. I will make sure that the Secretary of State for Education has heard his comments and I point him to Education questions on the 27th.

Saqib Bhatti: On Monday, working with Kathleen O’Hara and St Philip’s church in Dorridge, I arranged for a coachload of 60 Ukrainian refugees to come to Westminster so that they could see that not only my constituents, but the heart of democracy in our country stands with Ukraine. I could do that only because National Express donated a coach with two drivers to bring them here, which shows that, as Conservative Members believe, business is a force for good in society. Can the Leader of the House arrange a debate to discuss exactly that, so that we can celebrate the best of business, especially companies such as National Express that do great things?

Penny Mordaunt: Many hon. Members were grateful for the opportunity to meet those being hosted in my hon. Friend’s constituency. I add to his praise of National  Express for its generous donation. I also understand that St Philip’s church has been doing a huge amount to help hosting families and to make everyone feel at home. Many hon. Members are themselves hosting refugees, often the children of parents who are Members of the Ukrainian Parliament. That is a further example of how strong our resolve is and how our solidarity and friendship with Ukraine is growing.

Clive Efford: I know that the Leader of the House is interested in the future of football governance, and her concern for the future of her local football team is well documented, so will she be popping along to the Q&A that the Sports Minister is holding tonight, where he is charging people a £500 donation to the Conservative party for a briefing on the White Paper that is about to be published? Will she be paying £500? Is that common with legislation? Can we have a price list of what is charged for a private briefing on other legislation to make money for the Conservative party?

Penny Mordaunt: I do not know about the event, so I cannot comment on that, but nobody should need to go because, after I have finished at the Dispatch Box, the Minister will be here to talk about that precise topic. Hon. Members are welcome to ask him all kinds of questions—completely free of charge.

Lindsay Hoyle: On that point, I am very concerned because everybody on Sky News and every media outlet has had the ability to hear the announcement before the House. I am sure that the Leader of the House will agree that it should be in this House first, not all over Sky News.

Greg Smith: My right hon. Friend the Prime Minister was absolutely right, spot on and in tune with the vast majority of the British people when he made stopping small boat crossings, tackling the illegal and evil people smugglers, and ending illegal immigration into this country one of his top priorities. We are told that we need legislation for that, yet in today’s announcement, no small boats Bill was forthcoming. Can my right hon. Friend the Leader of the House assure me that that additional legislation will come before the House before the Budget? Will it have the same urgency behind it that we used for the Coronavirus Act 2020 and the United Kingdom Internal Market Act 2020?

Penny Mordaunt: I can reassure my hon. Friend on that point. We have done a huge amount. He will know that we have the new small boats operational command, 700 more staff and the work being done on accommodation by the Home Secretary. However, we do need new legislation to ensure that if people come here illegally, they should not be able to remain, but should be detained and swiftly removed. The Home Secretary has been working extremely hard to make sure that a really good Bill comes to this House. My hon. Friend will know, because we have said that we want Royal Assent before the summer, that that will come to this House very shortly. I know from having spoken to my colleagues on the Government side of the House that we are prepared to sit through the night, if necessary, to get this on the statute book as swiftly as possible. The country needs it and, quite frankly, the vulnerable people being trafficked and smuggled need it. I think it is an issue that other nations ought to be thinking about, too.

Marie Rimmer: Whistleblowers are essential to removing the veil of secrecy surrounding economic crime, corruption, sexual harassment and a host of other illicit activities across all sectors, public and private, yet they are putting their livelihoods and the livelihoods of their families on the line to reveal the truth. Will the Leader of the House work hard to ensure that the Commons gets a debate in Government time on the importance of whistleblowers and why there needs to be greater protection for them, which I hope would concentrate the minds of Ministers?

Penny Mordaunt: I thank the hon. Lady for raising this important point. I will certainly make sure that the Cabinet Office has heard the issues she has raised. I could give countless examples of where we have relied on brave people with moral courage to do the right thing, and we owe them protections. I think all Members of the House would agree with what the hon. Lady has said.

Lindsay Hoyle: I hope all of us would.

Christopher Chope: Leave aside sitting through the night, because so far this week—Monday, Tuesday and Wednesday—this House should have been sitting for 24 hours, but in fact seven hours and 47 minutes of that time was lost. I hope my right hon. Friend shares my concern about this, because so often the Government say we cannot debate things because we have not got any time. Will she ask the Procedure Committee to look again at the issue of second Adjournment debates, which used to be commonplace in this Chamber? That would ensure that this time was not wasted, and if the business was going to go short, it would be possible for people to come forward with a second, third or even, sometimes, a fourth Adjournment debate. We would thereby avoid getting a reputation as a part-time Parliament.

Penny Mordaunt: I will tackle my hon. Friend on the last point he makes. We have put through a huge amount of useful legislation, and he will know that we have plans to bring forward some really critical Bills to receive Royal Assent, we hope, before the summer recess. I am all in favour of innovation, so I shall certainly look at what my hon. Friend suggests. It is actually a refreshing change to have my hon. Friend complain about there not being enough legislation, as his usual default setting is to try to prevent any from going through at all.

Wera Hobhouse: Over 1 million households in England are currently stuck on social housing waiting lists. Thanks to my Liberal Democrat council, Bath is now building the first new council housing in 30 years, but clearly a lot more needs to be done to reduce the unacceptably long social housing waiting lists. Last year, 14,000 social homes were lost nationally, and the Government have failed to set targets to replace them. Can we have a statement from the relevant Minister on how the Government intend to tackle this real crisis in social housing?

Penny Mordaunt: The hon. Lady will know that we have been investing in social housing and removing some of the obstacles that have prevented developments going ahead. We have had the largest social housing programmes we have seen in this country in recent  years. I congratulate her and her constituency on getting some developments moving, and I shall make sure that the Secretary of State for Levelling Up, Housing and Communities has heard her concerns.

Selaine Saxby: Will my right hon. Friend join me in congratulating the George & Dragon in Ilfracombe on reaching the national finals of the Community Pub Hero Awards for its charity fundraising? Pubs do vital work in their local communities, especially in rural areas. Will it be possible to have a debate in Government time to highlight that work, the importance of pubs and how we can best support them during the current cost of living pressures?

Penny Mordaunt: I thank the hon. Lady for hosting me in her beautiful constituency last week. I join her in congratulating the George & Dragon on its success in the Community Pub Hero Awards. She is right that it is an incredibly important sector, not just for the facilities that pubs provide but for the fact that they are a community hub. She will be reassured to know that we will continue to support that pub and others through the energy bills discount scheme once the energy bill relief scheme comes to an end in March.

Emma Lewell-Buck: Yesterday, my constituents who lost their children in the Manchester arena terror attack met Ministers because they are being refused the right to register their deaths. In that meeting it was revealed that they have been misled by Government. They were then treated with contempt, patronised and insulted. They want to ask the Leader of the House what recourse they have for that treatment, or do they simply have to accept how low standards have sunk for Government Ministers?

Penny Mordaunt: I am sorry to hear the distress that the hon. Lady’s constituents are in. She did not pre-warn me of this issue, and I want to do my best to ensure that her constituents’ concerns are addressed. If she gives me more details I will look into it for her, because I am not aware of why there would be that obstacle to grieving parents doing an understandable thing for their lost child.

Rob Roberts: In my largely rural constituency, the love of animals ties my constituents together, from the oldest to the very youngest. I have had more constituency casework on this matter than almost anything, barring the parlous state of the NHS under Labour in Wales. Could the Leader of the House let us know when the Animal Welfare (Kept Animals) Bill will come back, please?

Penny Mordaunt: I thank the hon. Gentleman for raising this issue. I am afraid that business will be announced in the usual way, but I know that the Department for Environment, Food and Rural Affairs is looking at that Bill. I remind him that we are supporting the Hunting Trophies (Import Prohibition) Bill; we have introduced laws against hare coursing; and we have passed the Animal Welfare (Sentience) Act 2022. We have banned glue traps; we have set up the cross-Government pet taskforce; and we have maximised sentences from animal cruelty from six months to five years. We have passed Finn’s law and Lucy’s law; we have modernised our  licensing system; we have banned commercial third-party sales of puppies and kittens; and we have introduced mandatory CCTV in slaughterhouses. We have introduced many measures to improve the welfare of meat chickens, laying hens, cats, dogs, equines and pigs. We have banned the conventional use of cages for laying hens and we have introduced legislation against horse fly-grazing in England. I could go on, but I would be trying your patience, Mr Speaker. We care deeply about animal welfare and we will bring forward further measures shortly.

Stephen Farry: Last night in Omagh, County Tyrone, Detective Chief Inspector John Caldwell of the Police Service of Northern Ireland was brutally shot by cowardly masked men while he was coaching under-15s football. I am certain that Leader of the House would wish to join me in hoping that the officer recovers—he is critically ill in hospital—and in expressing solidarity with the brave officers of the Police Service of Northern Ireland, and the wider police family, as they uphold the rule of law and protect the wider community in Northern Ireland in the face of the ongoing terrorist attack.

Penny Mordaunt: I very much join the hon. Gentleman’s remarks. This has been a shocking attack. I am sure the whole House wants to send their good wishes and hopes that the officer makes a full and swift recovery. His situation is critical but stable. The Prime Minister has issued a statement on this appalling attack. We think about the ripple effect that it will have on members of the community—they and the officer are very much in our thoughts.

Nicholas Fletcher: There is a parcel of land in Tickhill in my constituency for which a controversial planning application for change of use to a Travellers’ site was refused. An appeal was made to the Planning Inspectorate in October 2021. We are now 16 months on, and no inspector has yet been allocated to the appeal. My constituents are obviously very unhappy at this delay. The inspectorate says that the delay is due to matters owing to the pandemic, and it cannot say when it will be remedied. I ask the Leader of the House if we can have a debate on how we deal with that backlog, because it is becoming intolerable for Tickhill Town Council and my constituents. I am sure that this frustration is mirrored across the country.

Penny Mordaunt: I am sorry to hear of the situation my hon. Friend raises. He will know that Planning Inspectorate services are under great pressure at the moment. The Department for Levelling Up, Housing and Communities is very much focused on improving the planning process and reducing the number of weeks that it takes for decisions to be made. Today the Department has published a cross-Government action plan on significant infrastructure projects, setting out suggestions to streamline and speed up the consenting process. That also matters for smaller projects that are less significant nationally but very significant to communities. I shall ensure that the Department has heard what my hon. Friend has said, and I hope that it is resolved quickly.

Stephen Doughty: I associate myself with the comments demonstrating the absolute unity across this House in support of Ukraine, ahead of the solemn anniversary tomorrow. I ask the  Leader of the House for a debate specifically about the organisations that are doing so much to support people seeking sanctuary in the UK, including from Ukraine. That includes organisations in my constituency of Cardiff South and Penarth. For example, at the Ukraine hub in Butetown, Helen and her team of Ukrainian volunteers have done so much to support Ukrainians seeking safety in the UK, as well as to get support out to Ukraine. Andrii and others have been raising funds for generators and other key products in Ukraine. The debate should also include all the organisations that support Afghans, Syrians and others fleeing terror, persecution and oppression around the world.

Penny Mordaunt: I thank the hon. Gentleman for giving all of us in this House the opportunity to thank all those organisations and the individuals behind them who are doing so much. We sometimes forget that those organisations have to adapt services. We all wish that the Ukraine war will be brought to an end swiftly. The needs of people who have been here for coming up to a year are quite different from when they first arrived; those organisations are constantly listening and adapting their service and offer. I am incredibly proud of them and everything our communities are doing to support not just Ukraine but many other places around the world where people are fleeing terror and war.

Kirsten Oswald: Today, 23 February, marks 54 days since the beginning of the year. It is the day on which women, on average, will find that they start being paid, because the gender pay gap between women and men currently sits at nearly 15%. A TUC study shows that the gender pay gap widens dramatically after women have children. It identifies that flexible working, including making family and caring leave work more effectively, is key to changing that. Presumably an employment Bill would be really helpful in changing the situation, but the Government are singularly unwilling to go down that road and put the focus on fairer work, as the Scottish Government have done. Can we have a debate in Government time on why fairer work matters, why the gender pay gap matters, and what can be done to ensure that this is changed once and for all?

Penny Mordaunt: The hon. Lady raises a very important point. I penned the gender equality road map for this Government, which looks at the impact, at every stage of a woman’s life, of the inequalities women face. We have introduced many measures off the back of that road map. The hon. Lady will know that we have recently been focusing on carers, and ensuring that they have more flexibility in their work. We are also focussed on ensuring people have the right to flexible working. If the hon. Lady wants to improve the situation in Scotland, then Scotland has all the powers it needs to do that.

Barry Sheerman: Does the Leader of the House agree that green skills provide this country with a real opportunity? Many young people who want an apprenticeship cannot get one. There is a crisis in our whole approach to apprenticeships. Will she arrange an early statement or debate on the skills shortage and on the potential to open up new curriculums and new opportunities to be apprentices in the green economy?

Penny Mordaunt: The hon. Gentleman is absolutely right. I agree with him completely. This is what we should be focusing on to ensure that our nation has the skills it needs to keep pace with emerging technology. He will know that the Secretary of State for Education does not just talk the talk; she walks the walk. As someone who has benefited from being an apprentice, she is absolutely passionate about this agenda, and I am sure he will be very pleased with what she does next.

Diana R. Johnson: Today the Lib Dem councillors in Hull will hand a bill to working families for the failures of Trussonomics. They are putting up council tax by the maximum rate possible without having to consult local taxpayers, and there is also an increase in the precept for the police and the fire and rescue service. That means that more than £100 will be added to council tax bills in what is already one of the most deprived and disadvantaged communities in the country. May we please have a debate about council tax and the need for a better, more equitable way of funding local government? It is also worth adding that the Lib Dems are putting up council rents in Hull by £30 a month. At the time of a cost of living crisis, that is not acceptable.

Penny Mordaunt: I am sorry to hear about that situation, and I fully understand why the right hon. Lady raises concerns about the Liberal Democrat council in her area. I have a Liberal Democrat council in my area and the themes are similar. We very much understand that it is the responsibly of us all, whether in national or local government, to ensure that people can keep as much of their money as possible. People are better at spending it than any local authority or Government. That is why we have raised thresholds and held down costs. In the time we have been in government, council tax has gone up by 36%. When we had a Labour Government, it went up by 110% over a similar amount of time. We are committed to doing what we can to hold down council tax.

Patrick Grady: Has the Leader of the House read the Hansard Society’s excellent working paper on proposals for a new system of delegated legislation? It contains excellent proposals that would allow this House to take back control from the Government’s Brexit power grab. If she will not implement all those recommendations immediately, could we at least have a debate in Government time on the Floor of the House about how we can improve the scrutiny of delegated legislation?

Penny Mordaunt: As I said earlier, I am very sorry that we are unlikely to have many more exchanges on Brexit from the Scottish National party. I say to the hon. Gentleman that Brexit is about taking back control. I hate to repeat a well-known phrase, but it is about empowering all parts of the United Kingdom to be masters of their own destiny. I am very happy to read any suggestions on procedure and on how legislation and discussion can be improved, but I gently say that we now have many more opportunities than we did when we were members of the EU.

Ruth Jones: The Leader of the House will be aware that Nexperia’s Newport Wafer Fab, which is in my constituency, is at risk of going  under because of decisions taken by this Government. I wrote to the right hon. Member for Welwyn Hatfield (Grant Shapps) when he was Secretary of State for Business, Energy and Industrial Strategy to request a meeting about the situation. He promised to meet me, but despite letters, emails and calls, no meeting took place. Given that the right hon. Gentleman has been reshuffled, will the Leader of the House advise me on who I should speak to now, and will she help me to finally get a meeting in the diary, because more than 500 jobs depend on it?

Penny Mordaunt: I understand the hon. Lady’s concerns. That particular Minister is very diligent, so I shall look into why she did not receive a reply. I think she will need to speak to the new Secretary of State. I shall make sure this afternoon that she has heard what the hon. Lady has said, and I hope she will be able to get access to a Minister to assist her.

Roger Gale: I call Jamie Law.

Jamie Stone: In six days’ time, NHS Highland will take away the right to give vaccinations from local GPs across the highlands. That will greatly inconvenience people and it is frankly dangerous. If a crofter cuts his or her hand on a piece of barbed wire, a tetanus injection is needed right away. It is unlikely that the two most relevant Members of the Scottish Parliament will do anything about it, because both of them are Ministers, and one of them wants to be the next First Minister. What the devil am I supposed to do in this situation to help my constituents, who are rightly very worried about this?

Penny Mordaunt: I am very sorry to hear about that. When we talk about the NHS, we often talk about patient-centred care. We should be thinking about the easiest, swiftest and most effective ways to serve the needs of patients and prospective patients. It sounds as though what the hon. Gentleman has described goes completely against that fundamental principle about what good care looks like.
The hon. Gentleman will know that Audit Scotland has a report out today on the state of the NHS in Scotland. Improvement is needed. There are big opportunities from using data and from innovation that Audit Scotland is urging the Scottish Government to take. I stand absolutely shoulder to shoulder with the hon. Gentleman and other Members of Parliament—Liberal Democrats and Conservatives—in wanting the Scottish Government to focus on those matters, which the people of Scotland need them to do. They are paying for a health service that they are being prevented from accessing.

Amy Callaghan: Cases of melanoma are rising across these isles. Will the Leader of the House grant a debate in Government time on skin protection from the sun, to raise awareness of skin cancer?

Penny Mordaunt: I thank the hon. Lady, who has a track record of raising awareness on a variety of issues, to the benefit of us all. I shall certainly make sure that the Secretary of State for Health and Social Care has heard her keenness to promote these important health messages. She will know how to apply for an Adjournment debate—we might be having more of those if I follow  the suggestion from my hon. Friend the Member for Christchurch (Sir Christopher Chope)—or she can apply to the Backbench Business Committee to secure the debate she wants.

Rachael Maskell: Investment in public health matters. In my constituency, we have a 10-year differential in life expectancy. However, the White Paper on health disparities has been scrapped, we do not have the tobacco control plan, there is no follow-on alcohol strategy and the public health workforce has been decimated. Given that the public health grant runs out in 36 days, can we have an urgent statement on what on earth this Government are doing about public health?

Penny Mordaunt: I thank the hon. Lady for raising that important point. She will know that I cannot comment on what is in the Budget, but I shall make sure the Chancellor has heard her concerns, and I am sure she has made representations to him. She will know that we are focused on particular aspects of healthcare at the moment, to ensure that we have the diagnostics we need to reduce waiting lists, but she is right: public health is key to this. It is absolutely key to prevention, which will be a fundamental part of ensuring a thriving NHS into the future, and I shall make sure the Secretary of State has heard her concerns.

Christine Jardine: The Edinburgh international festival is world renowned, but last year it shrank in size for the first time in seven decades. The King’s theatre in Edinburgh, which is in a neighbouring constituency, is facing a shortfall of £9 million. Its owners have described it as being in “the last chance saloon”, and it failed to get levelling-up funding last time round. The cultural life of Edinburgh is a massive contributor to the health of the Scottish economy and the UK economy. Does the Leader of the House think it would be appropriate to make time for a debate in this House on how the UK and Scottish Governments can contribute to the future stability and wellbeing of this vital industry?

Penny Mordaunt: I am very sorry to hear about the plight of that particular venue. The hon. Lady will know that we have Department for Culture, Media and Sport questions on 9 March, and I encourage her to raise the issue with the Secretary of State. The levelling-up scheme was hugely over-subscribed, but officials and Ministers will be meeting colleagues who did not have a bid granted in this round to look at what more can be done for the venues and projects concerned, or to improve the bid so that it is successful in future rounds. However, I understand the time concerns that the hon. Lady has, and I shall make sure that the Secretary of State knows about them.

Margaret Ferrier: Last week, as part of the Burnhill Action Group in my constituency, a group of children delivered winter care packages, with supermarket gift cards, a cookbook, an air fryer and more, to help locals with the cost of living crisis. Will the Leader of the House join me in thanking those young constituents for their care and hard work, and schedule a debate in Government time on the positive impact of youth volunteering?

Penny Mordaunt: I am very happy to pass on my congratulations, which I am sure are echoed by all Members, to the Burnhill Action Group. Youth volunteering is incredibly important; it sets good habits for the rest of our lives, and of course the contribution that those young people are making will teach them new skills and enable them to gain in confidence. I thank the hon. Lady for raising that point.

Fleur Anderson: Following years of campaigning by angry leaseholders and angry MPs such as myself, action on the national cladding scandal is just not going fast or far enough. The Government have made several welcome announcements since the Building Safety Act 2022 received Royal Assent in July. However, on the ground more than half a million people are still living in unsafe homes with unsafe cladding, and people face bankruptcy too. Will the Leader of the House allow time for a Government-sponsored debate—one or two questions at departmental orals just does not cut it, given the number of issues—so that we can work together constructively and end the building safety scandal once and for all?

Penny Mordaunt: I thank the hon. Lady for her question. She will know that the Secretary of State has taken unprecedented action in trying to get what is a very complicated situation resolved. I will just say that Levelling Up, Housing and Communities questions are on 27 March—the hon. Lady can choose to utilise those or not, as she sees fit. However, this is an incredibly important topic—people are still in limbo, and we want to make sure that they can move on with their lives and do what they need to do with their homes—and she will know how to apply for a debate.

Patricia Gibson: The decline of post offices in our rural and urban communities, including the loss of the post office on Kilwinning Main Street in my constituency, is truly alarming. Postmasters are struggling desperately to make a living. That is partly down to the fact that the last Labour Government stripped post offices of many of the services that they were able to offer and to this Government’s failure to provide the ongoing energy support that they so desperately need, as well to the banks not paying post offices properly for providing the services that they are no longer interested in providing. What representations will the Leader of the House make in Cabinet about ongoing and necessary support to save our post offices?

Penny Mordaunt: Post offices are incredibly important community hubs. Many services are run out of them, but they also provide a focal point. Often, they are not housed in distinct venues, and in some cases they are even in local pubs. They are incredibly important, and communities have been very creative in ensuring that they have that local presence. There will be good practice and advice that the hon. Lady can access to ensure that she does not lose those services for her community. I shall make sure that the relevant Department and the new Secretary of State have heard her concerns, and ask for an official to get in touch to see whether any of the good practice and learning that others have implemented will help with the situation she is in.

Jim Shannon: May I put on the record my thoughts and prayers, and those of my party, for the police officer shot in Omagh last night? It is a salient reminder that there are still evil and wicked people with murderous intent out there who wish to take us back to the dark days of the past.
This weekend, Nigeria is holding its general election, against a backdrop of violence and intimidation by security forces. Displaced religious minorities have effectively been disenfranchised, as the law requires voters to return to their home village to vote. A statement issued by the Foreign, Commonwealth and Development Office on Monday highlighted the issue of violence but neglected to mention displaced and minority groups, which I have an interest in. As our representative in Cabinet, will the Leader of the House ensure that the right of minorities to vote in Nigeria’s election is on the radar of this Government and thereby on the radar of Nigeria’s Government?

Penny Mordaunt: The hon. Gentleman is right to raise this issue. Our partnership with Nigeria is very deep, but unless we have democracy and security, nothing that we do subsequently will have any meaning or effect. I will contact those at the FCDO on the hon. Gentleman’s behalf and ask them to write to him specifically about the issue of displaced people and ensuring that they can exercise their democratic right to vote.
Let me end by saying that all our thoughts are with the injured police officer. We know that his community and others are incredibly strong and resilient and will never kowtow to those who committed this cowardly act, and I think that they should be full of hope at this moment too.

Roger Gale: I thank the Leader of the House for her statement, and ask Members who are leaving the Chamber to do so quickly and quietly.
Before we come to the next statement, let me say that Mr Speaker has asked me to tell the House that he is extremely disappointed that once again a Minister from the Department for Culture, Media and Sport has been briefing the media in detail about the Government’s plans before setting them out to the House. Mr Speaker notes that the news was embargoed until last night, rather than until an announcement had been made in the House, as should be the case. That is extremely discourteous. Mr Speaker has warned the DCMS about this matter before, and the DCMS should regard this as a yellow card. Mr Speaker does not wish to have to reach for a red card. This House must be treated with respect. I know that Mr Speaker looks forward to an early meeting with the Secretary of State.

Football Governance White Paper

Stuart Andrew: I take your point on board, Mr Deputy Speaker, but please forgive my enthusiasm for this great announcement that we are making today.
Let me start by offering my deepest condolences to John Motson’s family. John had an incredible impact over his 50 years working at the BBC, and his legacy as a legendary commentator will not be forgotten.
With your permission, Mr Deputy Speaker, I will make a statement on the Government’s reform of football governance. As I am sure many Members on both sides of the House will agree, in this country football is more than just a sport. It is part of our history, our heritage and our national way of life, bringing communities throughout the country together week in, and week out. We invented “the beautiful game”, and the Premier League and the English Football League are true global success stories, with matches exported and watched in 188 countries across the world and streamed into 880 million homes.
Despite this global success, however, it has become clear in recent years that there are systemic issues at the heart of our national game. Since the premier league was created in 1992, there have been 64 instances of clubs collapsing into administration. Some are historic clubs that we have lost forever, taking with them chunks of our history and heritage, and leaving huge holes in their communities. Bury football club is one example. Over its proud 134-year history, it managed to survive world wars, countless economic cycles and 26 different Prime Ministers, but it was driven to the wall by financial mismanagement, which damaged the local economy and left behind a devastated fan base. Those fans are still coming to terms with the loss of their beloved club. But it is not just Bury that has been affected: the same is true of Macclesfield Town, another century-old club, and of AFC Rushden & Diamonds. Countless others, such as Derby County, have been driven to the brink after stretching far beyond their means.
Despite the global success of English football, the game’s finances are in a parlous state. The combined net debt of clubs in the premier league and championship is now around £6 billion. Championship clubs spend an unsustainable 125% of their revenue on player wages alone and some clubs face annual losses greater than their turnover. Many, if not most, club owners are good custodians of their clubs, but all too often we hear of flagrant financial misconduct, unsustainable risk-taking and poor governance driving clubs to the brink. Owners are not just gambling with fans’ beloved clubs, but threatening the stability of the entire football pyramid.
Aside from the financial roulette putting clubs’ futures at risks, this is also about the way that fans have been treated. Over the past two decades, too many lifelong supporters have been let down, ignored or shut out by their own clubs. That has included the decision to move their stadium to a different part of the country, as happened with Wimbledon FC, or to change kit or badges without fan approval, such as when Cardiff’s owners tried to change the traditional kit of the Bluebirds, from blue to red. We also saw it with the European super league, when a small group of club owners planned,  without any engagement with their fans, to create a closed-shop breakaway league, which goes against the very spirit of the game.
Football would be absolutely nothing without those fans, and yet too often their voices have not been heard. But we have heard them. That is exactly why I made sure that my first meeting as Minister for sport was with fan groups. I heard at first hand how poor ownership and governance can leave clubs at the mercy of careless owners. In our manifesto, we committed to a root-and-branch review of football, with fans at the very heart of that review. That review, excellently chaired by my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch), highlighted a number of key issues that urgently needed resolving in football, and today we are acting on its recommendations, with the most radical overhaul of football governance since the rules were first invented in a London pub back in 1863.
With this White Paper, we will do five key things. First, we will bring in a new independent regulator to make sure that clubs are financially resilient. The regulator will operate a licensing system for all clubs in the top five tiers of English football. Those clubs will have to show that they have sound financial business models and good corporate governance before being allowed to compete. They will also be tasked with ensuring the stability of the wider football pyramid.
Secondly, we will strengthen the owners’ and directors’ test, to protect clubs and their fans from careless owners. There will be greater tests on suitability and on the source of funds. Thirdly, we will give fans a greater say in the running of their clubs. This will include stopping owners from changing vital club heritage, such as names, badges and home shirt colours, without consulting the fans first. Likewise, clubs will have to seek regulator approval for any sale or relocation of the stadium, and fan engagement will be a crucial part of that process.
Fourthly, we will give the regulator the power to block clubs from joining widely condemned closed-shop breakaway leagues, such as the European super league. Finally, we will give the regulator fall-back powers over financial redistribution. Supporting the pyramid is crucial and this Government have already committed £300 million of funding to support grassroots multisport facilities in England by 2025. When the financial health of the football pyramid is at risk, and football cannot sort out this issue, the regulator will have the power to intervene and protect the game. In short, we are protecting the long-term success of our national game, and restoring fans’ position at the heart of how football is run.
I want to reassure Members that this is not about changing the fundamentals of the game, or imposing unnecessary and burdensome restrictions on clubs. In fact, we would not naturally find ourselves in this space—having to regulate an industry that has enjoyed huge success without Government intervention over many years. However, despite the scale of the problems, and the huge harm that those problems can cause, the industry has failed to act, despite repeated calls for reform, so we have been forced to step in to protect our national game. This is about taking limited, proportionate action to maintain the premier league’s position as the strongest league in the world. It is also about safeguarding clubs across the country, from the biggest to those single- club towns where football sits at the very heart of the community.
This Government have proven time and again that we are on the side of fans. We committed to this review in our manifesto. We stepped in during covid to make sure that English football was one of the first leagues back across Europe. We got fans back into stadiums quicker than almost any other country, and we took action under competition law to support broadcasting revenues during one of the most difficult periods that sport has ever faced. That secured £100 million of funding for the game. We stepped in once again to block the European super league—a competition no fans wanted. When fans have needed us, we have been in their corner. Now we are putting them right back at the heart of football, and I commend this statement to the House.

Roger Gale: I call the shadow Minister.

Jeff Smith: I thank the Minister for his statement and for advance sight of it. The shadow Secretary of State is sorry not to be here. She managed to keep her diary clear on all the other days that we were warned to expect the White Paper, but on the day it finally arrived she had a commitment in her constituency. I echo the Minister’s comments about our sadness on the passing of John Motson. With the loss of Motty we have lost a real football legend.
Football clubs are at the heart of our communities. Football is a key pillar of our culture, society and economy, but it has long been in need of reform. Too often, decisions affecting our clubs have been made without reference to the fans, without whom football would be nothing. Historic clubs have collapsed because of the reckless actions of owners, and the perverse incentives created by pyramid finances. The longer we wait for change, the more clubs are at risk. Even now, Southend United is in crisis, facing a winding-up hearing next week. There is still no agreement between the Premier League and the English Football League on financial redistribution. Rumours continue about revised proposals for a new European super league. We are regularly reminded that this is an urgent issue.
Labour’s support for football reform and a fan voice has featured in all our manifestos dating back to 2010. That is why Labour welcomes the measures set out in the White Paper. We will look at the detail, but we strongly support the key proposal for the creation of a fully independent regulator of English football. Indeed, we backed the implementation of all the recommendations of the fan-led review from the beginning. Once again I thank the hon. Member for Chatham and Aylesford (Tracey Crouch) for her leadership in getting us to where we are today, but I must ask the Minister why it took us so long to get here.
The excellent fan-led review report was published in November 2021. When the Government responded last year they said they would back all 10 strategic recommendations. They delayed—too consumed by chaos in the Tory party and the Government—and the promise to legislate was watered down to the publication of a White Paper. The White Paper was promised for months, and although we were finally told that we could expect it weeks ago before recess, instead it was leaked to The Sun newspaper. In the meantime, more clubs have struggled and come near the brink of collapse. I am pleased that we are finally making progress, although today’s announcement  should not really have been about a White Paper; it should have been about a Bill. It is not clear how much more we will learn from a consultation on a White Paper that was not already explored by the fan-led review, which had wide-ranging fan and stakeholder input, supported by an expert advisory panel.
Given where we are, Labour wants to use the opportunity to help the Government make the future Bill as strong as possible. In welcoming the broad proposals, I ask the following questions of the Minister. First, financial sustainability is at the centre of the fan-led review. We need a regulator with sufficient teeth to ensure that our game as a whole is sustainable, as well as individual clubs being sustainable. We look forward to seeing the full detail of powers that the regulator will have to step in on issues such as redistribution if the football bodies do not resolve them. What can the Minister say about the review’s recommendations on other important financial issues such as the transfer levy, parachute payments, or sustainable player contracts?
The fan-led review proposed what was called a golden share, which is simply a requirement that there should be democratic fan consent for actions around heritage items such as club colours, names, badges, or relocation outside the local area. How will that supporter consent be guaranteed? When the White Paper was leaked, The Sun reported that the then Secretary of State wanted legislation in place for the 2024-25 season. Will the Minister lay out the consultative and legislative timetable that would allow that to happen? Is it the intention to legislate in this parliamentary Session, and how soon does he think we can get a Bill passed and an independent regulator up and running? Those are important and fundamental questions, because our national game needs action and change. Football fans have waited long enough.

Stuart Andrew: I am grateful for the support that the hon. Gentleman has indicated today. We all recognise that action needs to be taken, and I am grateful for that support from the Opposition. I accept that time has been taken, but it is important to put on record that these are not simple matters. They are complex, and it has been important for us to ensure that we get this right. I have not been sitting on my hands; I have dedicated considerable hours to this, building on the extensive work in the review led by my hon. Friend the Member for Chatham and Aylesford.
The hon. Gentleman is right to talk about the finance side of things, and of course the regulator will have the teeth it needs to ensure support for the whole of the game. On fan voice, although we have not gone down the golden share route, the voice of fans is front and centre in this White Paper. It will basically achieve exactly the same thing, and it will be a condition of a licence for clubs to compete in English football. I am extremely grateful for the offer of support on the Bill, and I look forward to working with the hon. Gentleman as we try to progress it through the House.

Roger Gale: I call the chair of the fan-led review of football governance.

Tracey Crouch: I join those on the Front Bench in paying tribute to John Motson. He was not just a commentator of great football matches;  he was a commentator inside the head of millions of kids playing football in their back garden. He commentated many times on my Ricky Villa-esque swerves around flowerpot midfielders, and my Gazza-style chips over defenders, before my Clive Allen-style cup-winning glory goals against the back wall. His voice was unique, his expertise second to none, his sheepskin was iconic, and he will be much missed.
I thank the Minister for the White Paper. It has, I know, been a painstaking experience for him, but we are here due to his perseverance, and that of his officials. The White Paper honours and reflects the vast majority of recommendations in the fan-led review, which I and the panel, and the thousands of fans who contributed, appreciate. I genuinely believe that the White Paper does nothing to threaten the competitiveness, wealth or attractiveness of the premier league, but it will protect English football from vulnerabilities that in the past have had devastating consequences. I appreciate that we will now go away and look at the detail of the White Paper. I also appreciate, Mr Deputy Speaker, that I have to ask a question in response to the statement, so is the Minister able to set out his vision for the timeframe for the next steps of the White Paper?

Stuart Andrew: May I again put on record my thanks for all the considerable work done by my hon. Friend in this area? She is right to highlight the fans, and they have been at the forefront of my mind in all the meetings I have held to discuss the White Paper. I agree that there is no threat to competition within the White Paper. If anything, it will bring about a great deal of confidence, and I hope we will see even more investment—dare I say from the right people? On the time frame, we will be doing a short, targeted consultation following the publication of the White Paper. My vision is to get on with this as quickly as possible, and I know that the Secretary of State shares that as far as—Members will expect me to say this—parliamentary time allows. In the meantime we are also considering the establishment of a shadow regulator to do much of the preparatory work, so that once it is enacted, the regulator can get on with the work straightaway.

Clive Betts: I welcome the White Paper, which contains most of the important recommendations of the fan-led review. Most football fans in this country will not read the White Paper, and probably do not have an understanding of our deliberations here, but if we do not implement this and get it right, the same devastating consequences will befall some clubs over the next few years as have already befallen clubs such as Bury.
One of the most important things is that the enormous wealth of football is distributed more fairly through the whole pyramid. The Minister says the regulator’s powers will be a fallback, but I think they will be necessary. Paragraph 9.12 of the White Paper talks about the regulator deciding on the
“issues that any financing would need to address.”
Is it not more than that? The regulator needs a steer from the Government and from this House on what those issues should be. Does the Minister accept that the issues are twofold? We should have a fair distribution that, first, ensures the sustainability of all clubs throughout the pyramid and, secondly, prevents the cliff edge of parachute payments, which create unfair competition at various points in the pyramid.

Stuart Andrew: I am grateful to the hon. Gentleman for his work and for his extensive interest in this important area. He is right that we have to get this right, and that the implementation of the independent regulator will be critical. He is also right to talk about the distribution. We have secured powers for the regulator to use should there not be an agreement between the football authorities. We still urge them to get on with it. They can still come up with a deal, and I sincerely hope they do. As we progress towards legislation, we will be looking for the steer he mentions so that we can get on with the deal that everyone expects and for which they have waited far too long.

Roger Gale: I call the acting Chair of the Select Committee.

Damian Green: I congratulate the Minister on not only producing this long-awaited and welcome White Paper but on broadly agreeing with my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch), which in my experience is usually the easiest and quickest way to reach a conclusion.
The House knows that the Premier League is one of this country’s most successful businesses, exports and brands. The key issue for fans is how much can be squeezed from this golden goose without damaging it, so that we can give proper, long-term and sustainable support to clubs lower down the professional pyramid and, indeed, to the vital grassroots of football. Whatever happens, and however quick the consultation, the regulator will not be in operation for another 18 months or two years. How long does the Minister propose to give the game to sort out the key issue of the distribution of money?

Stuart Andrew: I thank the acting Chair of the Select Committee. He is right to point out that the premier league is the most successful league in the world. We were careful not to do anything to damage it as we developed our thoughts in the White Paper. He is right to talk about the importance of grassroots sport. In every meeting, I have urged the EFL, the Premier League and others to come to a deal and to get the distribution of payments sorted out as quickly as possible. Only when we have the regulator in place will the powers be available for a deal to be struck, but I urge the people in those negotiations to get on with it, and to get on with it quickly.

Roger Gale: I pay Jamie Stone the courtesy of calling him correctly.

Jamie Stone: I associate myself and my party with the sadness expressed on the passing of John Motson.
Well done, His Majesty’s Government. I think Kieran Maguire, the host of “The Price of Football,” will be very pleased with what has been said today. I am the only Scot remaining in the Chamber, but I believe football is for everyone, on whichever side of the border they live. Scotland has gone some way down this road. I appeal for everything humanly possible to be done to co-ordinate with Scotland and Wales to make sure there is a universality of approach, because we can learn from each other to get it right.

Stuart Andrew: The hon. Gentleman is absolutely right. As a proud Unionist, I am more than happy to work with my counterparts in the devolved nations. If we want to have a lesson on how to deliver sustainable football, we will happily talk to our Scottish colleagues.

Helen Grant: I welcome the White Paper, on which I congratulate the Minister and the Secretary of State. I also congratulate my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) and her team on their excellent work on the fan-led review.
I especially welcome the proposal for an independent regulator for English football, but will the Minister please confirm that the financial powers of the regulator, which are essential to rebalancing the game, are not just powers of last resort? If they are, it will surely be a potential lost opportunity.

Stuart Andrew: It is always hard to answer questions from my predecessors, but it is a privilege to do so. My hon. Friend is right to talk about the financial support needed by the whole pyramid. I can assure her that we have made sure the provisions of the White Paper and the powers of the new independent regulator will be there if there is no agreement, but I still believe that football can come up with a solution, and it needs to do so quickly.

Clive Efford: I welcome the White Paper and pay tribute to the hon. Member for Chatham and Aylesford (Tracey Crouch), but I take issue with the paragraph that says:
“Both the Premier League and EFL are in agreement that a greater quantum of cash needs to flow through the pyramid”
That is absolutely not true. The position of the Premier League is that it should continue with the parachute payments, which is the impasse to our getting a fairer distribution of resources. Ministers can stand at the Dispatch Box and say they have pleaded with the two parties to come together to reach an agreement, but it will simply not happen because of the intransigence of the Premier League. We cannot wait for the independent regulator to go through all the processes set out in chapter 9 before coming to a decision about what side to come down on in that argument. We need urgent action, otherwise other clubs could disappear. What will the Government do to urgently address that issue?

Stuart Andrew: If we had not published this White Paper, and if we did not have the intention to introduce an independent regulator, there would be no option for bringing the parties together to make sure a deal is secured. The regulator will look at the detail of the deal, and it will be able to consider issues such as the parachute payments. The independent regulator will have those powers.

Damian Collins: It is wonderful to see ideas presented as Government policy that many of us in this House have been advocating for more than a decade. I fully welcome the White Paper, but will the regulator have the power to demand access to real-time financial information from the clubs, and not just rely on the clubs to self-report their own budgets and forecasts? As we know, failing clubs often try to hide that they are failing for as long as possible, often until it is too late.

Stuart Andrew: My hon. Friend is absolutely right. It is important that the independent regulator has access to that real-time information. In preparation for legislation, we are considering exactly what we need to do by learning lessons from other regulators, such as the Financial Conduct Authority, to ensure that the independent regulator has the power to look at the proper figures on owners’ wealth and the source of that wealth. That will give confidence and stability to the whole football pyramid.

Rachel Hopkins: I, too, welcome the publication of the White Paper. I agree with Gary Sweet, from Luton Town, that an independent regulator will
“provide all clubs with the fairest opportunity to compete through sporting endeavour whilst operating sustainably, with the inclusion of supporters and influence on their communities.”
I wish to press the Minister on the supporters’ voice element, given the absence of the golden share mechanism. Can he assure me that there will be formal recognition of the supporters in any shadow regulator or regulator, to ensure that licence conditions that affect fans so much can be considered in a formal sense?

Stuart Andrew: I absolutely can give that guarantee. One of the four thresholds to securing a licence to compete within English football will be the fan interest—that will be an important element. Those clubs will have to demonstrate that they are regularly engaging with their fans, and talking about the strategic plans they may have for the club and other important aspects, such as the club heritage. Throughout this, the fans need to be front and centre of everything the regulator is thinking about.

Siobhan Baillie: My brother and sister—the whole family—are complete football nuts, so I know from them that, because I do not spend every weekend on the terraces, I should not comment on football. What I do know, however, is how important football is to communities, and seeing Forest Green Rovers fans in Nailsworth on match day, all over Stroud district and in schools whenever I visit is a genuine joy. Other Members have raised concerns, which I share, on the speed with which the football wealth will flow down to the lower leagues, but I want to press the Minister on the fact that the Forest Green Rovers owner wants the regulator to regulate the environmental performance of clubs as well. Forest Green Rovers are an absolute beacon in that regard. Does the Minister envisage sustainability being part of the regulator’s work or that of the football authorities? Will he meet Forest Green Rovers to discuss that matter?

Stuart Andrew: I thank my hon. Friend for her question and she is right to highlight the great experience that so many fans at Forest Green Rovers have each week. The independent regulator will primarily be focused on financial stability, but I assure her that, whenever I have opportunities to raise issues such as sustainability, I always do so. Of course, I would be more than happy to meet as she requests.

Mary Glindon: Further to what the Minister has said about the redistribution of funds, how will he ensure that funding gets down to the real grassroots, not just to the lower leagues?

Stuart Andrew: I assure the hon. Lady that for me grassroots football and grassroots sports are really important. It is a force for good in so many ways. It is important in increasing people’s activity levels, it is good for their mental health and it has so many other benefits. That is why we have already committed nearly £300 million for the provision of grassroots sports facilities. We will continue to work with the Premier League, the EFL and others across sport to encourage more investment in grassroots facilities, because we recognise the huge benefits that brings to the population as a whole.

Katherine Fletcher: Fans in South Ribble of proper football clubs such as Manchester United—I am aware that there may be others—were deeply worried about the European super league and will hugely welcome the regulatory proposals to prevent a travesty such as that happening in future. So I thank the Government, but I note that this is covering only the men’s game at the moment. We have LetGirlsPlay Day coming up on 8 March, when junior schools such  as St Mary Magdalen’s Catholic Primary School in Penwortham and St Catherine’s Catholic Primary School in Leyland will be encouraging women and girls to get involved. What does this review have to say to women’s football, in order to both increase ground-level participation and ensure that investment is going into the ever-expanding women’s professional game?

Stuart Andrew: My hon. Friend is right to raise that important issue, which was of course an important area of work within the review. I am pleased to say that we have set up an independent review of women’s football. We can all celebrate the wonderful expansion in the popularity of women’s football that we have seen since the Lionesses’ tremendous success. I have been meeting colleagues within the Department for Education to talk about the provision of sport for women and girls, because we recognise that that is an important area of work. I am looking forward to that review concluding and providing its report. Obviously, we will give our comments on it once it is published.

John Martin McDonnell: I declare an interest, as honorary vice-president of Hayes & Yeading United football club. May I turn the Minister’s attention to page 50 of the White Paper? It looks at enhanced due diligence on sources of wealth, which I welcome completely. In the engagement process that the Government are now going to undertake, will we also look at other criteria as to sources of wealth? In particular, I am thinking of sources of wealth from state funds, sovereign funds and individuals associated with regimes that have records of human rights abuses. Such criteria are being introduced on the London stock exchange and elsewhere, and they need to be taken into consideration, because of the reputational damage to the individual club and to the country.

Stuart Andrew: I thank the right hon. Gentleman for his question. We are going to look at all these issues in preparation for the legislation and we will, of course, look at the issue he mentions as part of the consultation that will happen following the publication of the White Paper.

Louie French: Following years of misery and uncertainty for fans at local clubs such as Charlton Athletic, I welcome the news on an independent football regulator. Will the Minister assure my constituents that the regulator will have sufficient powers to deal with regulatory breaches and strengthen those ownership tests?

Stuart Andrew: Absolutely. This is why we will make sure that the independent regulator is backed by legislation; we want to ensure that it has the powers that are needed. We need to ensure that it has the sanctions needed so that it can do the important work that we are commissioning it to do. My hon. Friend is right to highlight those specific areas and as we develop the legislation we will ensure that that aspect is as strong as possible.

Jim Shannon: I thank the Minister for his statement and very much welcome the publication of the White Paper and the strategy that has been outlined.
Amateur leagues in Northern Ireland— I know that that is not the Minister’s responsibility, but I use it as an example—are thriving. People of all ages and abilities are encouraged to train, play and attain physical fitness. How can we ensure that all levels of football can be enhanced through the application of this report’s findings? What will his Department do to help smaller and amateur leagues because it is important that they are part of this process?

Stuart Andrew: I have mentioned, time and again, in the many Westminster Hall debates in which the hon. Gentleman has appeared that leagues such as those he mentions are incredibly important. I see my job as dealing not just with the professional side of the football pyramid; all those amateur clubs are incredibly important, as they do so much good work in our communities. Supporting them will be incredibly important and they will feature heavily in the sports strategy that we will develop very soon.

Nicola Richards: Football would be nothing without the fans, which is why I am so pleased that the Government are putting them at the heart of football governance. Today, we are sending a clear message that, regardless of which team Members support, we are all on the same side as the Baggies fans in our fight for our club. I congratulate the Minister on the publication of the White Paper, which is world-leading. While he continues to support us with ongoing issues at West Bromwich Albion, will he meet fan groups that he has joined me in championing?

Stuart Andrew: First, I pay tribute to my hon. Friend and my hon. Friend the Member for Dudley South (Mike Wood), who have been diligent in campaigning hard on behalf of their local fans. I would be more than happy to meet them. As I said, I ensured that my first meeting as Minister was with fans, because I wanted to hear their voice loud and clear, and I am glad that through this White Paper their voices will be heard loud and clear by the regulator.

Ian Mearns: May I declare an interest, as the chair of the all-party group on football supporters, the secretariat of which is supplied by the  Football Supporters’ Association? Kevin Miles, its chief executive, is with us in the Gallery today. Fans are the lifeblood of clubs, not just an asset to be cynically sweated, as was said by Mike Ashley when he took over Newcastle United about 14 years ago. I really welcome this White Paper, although it is long-awaited. The Minister said that before legislation is passed he would establish a shadow regulator that would do some scoping work to closely analyse what is happening on the ground now, and the preparatory work so that, once the regulator is properly established and underpinned by legislation, it can hit the ground running. Will he now commit to setting up that shadow regulator?

Stuart Andrew: I am glad the hon. Gentleman referred to Kevin Miles and all those at the FSA. They were the group I was talking about a few minutes ago and I was particularly struck by some of their horrific stories, including that of Blackpool fans who had to boycott their own club for five years, which shows the huge sacrifice they were making.

Ian Mearns: There is a long list.

Stuart Andrew: Absolutely, there is a long list. I can assure the hon. Gentleman that I am actively looking at the shadow board and, while I cannot make that commitment right now, I understand the merits of our having one.

Brendan Clarke-Smith: We have heard about the importance of having good owners. In Bassetlaw, we are fortunate to have both Worksop Town and Retford United top of their respective leagues, but I am a Notts County supporter, and we have pretty much been through it all over the years. I have seen the club in administration for a record period, unscrupulous owners and the fans trying to take over the club, which did not quite work out either. Now things are a bit better and we are top of our league as well, due in no small part to 30 goals from our “non-league Haaland”, Macaulay Langstaff. The problem is that the football authorities have failed time and again with clubs up and down the country, whether on financial fair play or the fit and proper test. Can the Minister reassure us that the independent regulator will put right many of the things that the football authorities have managed to get so wrong over the years?

Stuart Andrew: I know some within football are somewhat critical today of our publishing this White Paper and our intention to establish an independent football regulator, but they had their chance. They have had many opportunities to sort this out and have failed to do so. It is precisely because of the examples that my hon. Friend rightly points out and the difficulties that so many fans have experienced in the past that we have stepped in and we will sort this out.

Marie Rimmer: Will any strengthened owners and directors test overseen by the independent regulator take into account human rights violations, and will it make a proper assessment of ownership and bids that are likely to be connected to state ownership?

Stuart Andrew: The hon. Lady raises an important point. While this is not about a foreign policy, we will ensure, first, that we know who the owners actually  are—I have had examples of some clubs that have no idea who actually owns the club—and, secondly, that that person will have to go through a vigorous fit and proper person test, so we can examine the points that I think all the fans want examined. Fans want to know that owners have the best interests of their clubs at heart, just as they do.

Anna Firth: Southend United football club is the heartbeat of our local community, but that heart is currently on life support. Will the Minister pay tribute to the Shrimpers Trust, the ShrimperZone and The Blue Voice for all they have done to keep Southend United going? They will warmly welcome this White Paper and having a greater say in the running of their club, but will the Minister confirm that the strengthened owners and directors test in the White Paper should mean that Southend United’s current situation will never be repeated?

Stuart Andrew: I congratulate my hon. Friend and pay tribute to her for the enormous amount of work she is doing on behalf of her constituents and the fans at Southend. She has been relentless in pursuing me on this issue and I am sure the fans will be extremely grateful to her for that. She is absolutely right: the independent regulator will be monitoring the situation in each club at a much earlier stage so that there can be intervention, if necessary, before we get to the crisis point, to put those clubs on a stable footing so that they can be there not only for the people who enjoy them today, but for their children and grandchildren.

Roger Gale: Finally, I call the patient James Wild.

James Wild: Thank you, Mr Deputy Speaker. I declare an interest as a Norwich City season ticket holder and King’s Lynn Town supporter.   I welcome the White Paper’s focus on a sustainable and competitive game, but introducing new regulation should be the last resort, so we need to ensure this is a truly proportionate regime. Given the focus on fans, will my right hon. Friend consider proposals to allow non-league clubs that took out sport survival loans, the repayment of which may threaten the viability of some, to convert those loans into equity gifted to supporters’ trusts, leaving a legacy of greater fan ownership of community clubs? Will he meet me to discuss those proposals?

Stuart Andrew: My hon. Friend is right that it is disappointing that we have had to step in here to introduce the regulation. That is why we have taken time. We are ensuring that it is proportionate. We do not want to put too much pressure on the clubs that are lower down the league, but we need to ensure they are run properly. He is asking me to make a spending commitment; I think my colleagues in the Treasury would be extremely cross with me if I committed to that, but I am more than happy to meet him to discuss his proposal.

Bill Presented

Holocaust Memorial Bill

Presentation and First Reading (Standing Order No. 57)
Secretary Michael Gove, supported by the Prime Minister, the Chancellor of the Exchequer, Secretary James Cleverly, Secretary Suella Braverman, Secretary Kemi Badenoch, Secretary Gillian Keegan and Secretary Lucy Frazer, presented a Bill to make provision for expenditure by the Secretary of State and the removal of restrictions in respect of certain land for or in connection with the construction of a Holocaust Memorial and Learning Centre.
Bill read the First time; to be read a Second time tomorrow, and to be printed (Bill 254) with explanatory notes (Bill 254-EN).

Backbench Business

Future of the NHS

Kate Osborne: I beg to move,
That this House has considered the future of the NHS, its staffing and funding.
The national health service is a beloved national institution. Everyone in the country and in this House will have interacted with the NHS and have their own personal connections and stories that they can reflect on, from the birth of their children to the death of a loved one or seeing a general practitioner about a health condition. It is undeniable to most of us that the NHS is in crisis. It is being pushed into an avoidable and unprecedented collapse after 13 years of Conservative mismanagement.
All our constituents will have been impacted in some way by the crisis, a crisis so bad that nurses have taken strike action for the first time in NHS history. Ambulance workers and other NHS staff have also taken action, and this week British Medical Association junior doctors voted with a 98% majority to do the same. I thank all my constituents who work in the NHS, particularly those who got in touch about this debate, including paramedics from the North East Ambulance Service who tell me that on a daily basis they are unable to hand over patients because of delays in A&E and lack of beds, and how frustrating it is that many of the calls are for people who need social care or cannot get a GP appointment, rather than the acute calls that they are best placed to deal with.
That highlights the impact the crisis in social care is having on the NHS. Half of all people arriving in A&E by ambulance are over 65 and one third are over 75. The lack of adequate social care for basic daily needs is storing up problems and leaving older people less able to care for themselves, or arriving in hospital with preventable health problems, adding to the pressures in A&E and bed provision. People who work in the NHS have had enough of being failed by this Government’s mismanagement. The country deserves better.
NHS dentistry is on its knees, with patients facing a growing crisis of access and resorting to DIY dentistry. The NHS was in crisis pre-pandemic and the Government’s failures and mismanagement have made the situation far worse. For Ministers to dismiss the crisis as winter pressures, or even to flat-out deny that there is a crisis, is frankly absurd.

John Martin McDonnell: The crisis in dental and mental health is affecting our children at the moment. In some of our constituencies, it is a direct result of the lack of local provision. We are feeding a generation of problems as a result of that failure.

Kate Osborne: I absolutely agree with my right hon. Friend. The problems for our children further down the line are worrying, but of course, they are preventable if the right action is taken.
The Conservatives blame everything else—the weather, the pandemic and even NHS staff—but their 13 years of failure have left the health service in crisis. At Prime Minister’s questions yesterday, the Prime Minister boasted about
“record sums into the NHS…and…a clear path to getting people the treatment they need in the time they need it.”—[Official Report, 22 February 2023; Vol. 728, c. 222.]
He is not living in the real world. Every briefing and communication that we have received has cited delays in treatment and the devastating impact that they have, as well as the decade of underfunding. It is hard not to agree with the British Medical Association, which called the Prime Minister “delusional”.
The last Labour Governments allocated, on average, a 6% rise in the NHS budget every year. Successive Conservative and coalition Governments have since allocated a rise of only 1% a year. The Prime Minister can talk about “record sums” all he wants, but he is fooling no one. In reality, the settlement is not enough, and it is nowhere near what previous Labour Governments invested. This crisis can be laid firmly at the Government’s door.
There are so many awful headlines and statistics, and I will delve into some of them, but let me say from the outset that we must all remember, when we talk about the 7 million people on waiting lists, or the 500 avoidable deaths every week, that we are talking about people. There are faces behind those statistics: the faces of women who cannot get urgent gynaecological treatment, the faces of children who cannot access mental health support, the faces of families whose loved ones have died—lives that could, should and would have been saved if this Government cared about communities and invested in our NHS.
When we talk about 133,000 NHS vacancies, we are talking about people who have left their work in the NHS because they cannot cope financially or emotionally, we are talking about the rest of the workforce working harder to pick up the slack, we are talking about the NHS being unable to recruit because of poor wages and conditions, and we are talking about the impact that that has on patients.
The only way to solve the NHS staffing crisis is by sorting out pay. The Government agreed yesterday to negotiate with the Royal College of Nursing, and nursing strikes have been paused for those negotiations to happen. The Government could have agreed to negotiations months ago, but they chose not to. Negotiations with the RCN alone will not solve the staffing crisis. Junior doctors have voted by 98% to strike, but the Health Secretary has not even offered a meeting. Negotiations with one section of the NHS workforce are not sufficient; all unions representing NHS staff need to be negotiated with. The Government must make a pay offer that is not linked to efficiency savings and productivity, because NHS staff are already working unacceptably long shifts.
An offer—such as the one we saw on Tuesday—of 3.5%, when inflation is at least triple that and NHS workers’ pay is worth less than it was a decade ago, is, as Sharon Graham of Unite the Union said, a “sick joke”. Christina McAnea of Unison announced further strike days next month. The Government are failing to resolve this dispute; instead, they are attempting to blame workers for putting patients in danger. Patients will never forgive the Conservatives for refusing to negotiate and using patients as bargaining chips.
The staffing crisis must be urgently addressed. The impact of waiting times on individuals can be severe and the consequences irreversible. Two hundred people in my Jarrow constituency have Parkinson’s disease.  Parkinson’s UK is concerned about people waiting longer than two years for a diagnosis. Similarly, the MS Society has said that more than 13,000 people have been waiting more than a year for a neurology appointment. Those delayed diagnoses and treatments have a hugely detrimental impact on the individuals concerned.
Delays in cancer diagnosis and treatment are life-threatening. For years, the Government have missed cancer targets because of a lack of concerted action on matched funding. In South Tyneside and Sunderland NHS Foundation Trust, only 73% of people were treated within the target of two months following a cancer referral, and only 61% of people are treated within that target nationally. The UK is being left behind, and people are dying avoidable and preventable deaths. That is why we need a workforce strategy—yes, to pay people properly, but also to enable the NHS to save people’s lives.
Labour has a workforce strategy, while the Government have not even committed to fully funding their promised workforce plan. The Chancellor praised Labour’s plan, so why does he not put his money where his mouth is by implementing it? Labour will deliver a new 10-year plan for the NHS, including one of the biggest ever expansions of its workforce.

Alex Cunningham: I congratulate my hon. Friend on securing the debate. This will come as a surprise to her, but I have visited a private health provider in my constituency in the last fortnight. People there told me that they are recruiting staff directly from university, so people are trained at the state’s expense but are then used for private profit. That means that the health service, which cannot afford to pay the same wages, loses out. Does she have any ideas about how that might be sorted out?

Kate Osborne: I will address my hon. Friend’s point in my remarks. This Government’s ideological commitment to the free market has led them to force through more and more privatisation of our national health service. Some Government Back Benchers are talking openly about moving to an Americanised healthcare system in which people are priced out of healthcare, and they have even mentioned it in this Chamber. We have seen corrupt contracts for cronies, and friends of the Government making millions while people suffer. The Government have allowed the private sector to run rampant, taking hundreds of billions out of the NHS budget over the last 10 years.
It is as if the Government are on a mission to destroy the NHS as we know it. They have even performed smash-and-grab raids on hospital repair budgets, taking £4.3 billion away and leaving hospitals crumbling, leaking and falling apart at the seams. Fifty per cent. of trusts now have structural issues with leaks, collapsing floors, raw sewage and unsafe wards.
American news agency CNN said last week:
“Britain’s NHS was once idolized. Now its worst-ever crisis is fueling a boom in private health care.”
The number of people paying privately for operations is up 34% in 2022. If that trend continues, it will embed a two-tier service in our NHS and price many people out of healthcare. My constituent Christine was referred to  a private health company by her GP, while another constituent, Ray, was told that he could no longer get a service from the NHS and that he would need to pay privately, at a cost of £50. Ray said to me:
“As I am 74 years old and rely on my state pension it makes it very difficult for me in the current economic climate to pay this amount. Having paid national insurance contributions for 50 years, I don’t understand. Why do I have to pay again?”
I look forward to receiving a response for Ray from the Minister.
Ray is correct, of course. As Nye Bevan said:
“No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”
As with any crisis, companies step in to exploit the situation and make money.

Florence Eshalomi: I thank my hon. Friend for making such a powerful speech on a really important issue. A fantastic GP surgery in my constituency, the Waterloo Health Centre, is closing because the landlord is selling to a private developer. Many people who have used that GP service for decades are now worried about where they will register. A number of people across the country are waiting to register with NHS GPs, and waiting lists continue to grow. Does she agree that that is another example of the private sector coming in and making it really difficult for our NHS system?

Kate Osborne: Yes. We have all seen for ourselves and heard from our constituents how difficult it is to get an appointment, and the private profiteers are driving that.

Richard Burgon: I congratulate my hon. Friend on securing this important debate and making such a powerful case. On the subject of privatisation, does she share my concern that, as we have heard in recent speeches in the Chamber by Conservative Back-Bench MPs, this is entirely deliberate? They want to manufacture consent among the public for a move to an insurance-based, American-style system by more and more people feeling forced to take out health insurance or pay for healthcare, so that over a number of years, we see healthcare provision go down the same path as council houses, which went from mass provision to minority provision.

Kate Osborne: I agree that if things do not change, that is exactly the route we are going down.

Rachael Maskell: I congratulate my hon. Friend on securing the debate. Does she acknowledge that this has already happened in dentistry, with families taking out dental plans because they cannot access an NHS dentist?

Kate Osborne: We are seeing this across the whole NHS, including dentistry, as my hon. Friend rightly says.
As with any crisis, we see companies step in to exploit the situation and make money. US group Cleveland Clinic plans to open its third UK facility in London later this year, adding to the 184-bed hospital and six-floor clinic that it opened in 2021 and 2022 respectively. HCA Healthcare, another American group, which has over 30 facilities in London and Manchester, will be  opening a £100 million private hospital in Birmingham later this year. Some 40% of private mental health companies need safety improvement, and we are handing over billions to companies that are failing our constituents.
Too much of what is happening is hidden from Parliament and from the public. Where is the accountability for these private companies? Labour’s plan for the NHS includes working with partners to ensure patient safety and to bring down waiting lists. What it does not include is the rampant corrupt profiteering, with contracts for cronies and profit put above patients, that this Government are presiding over.
In England, we have a 20-year gap in life expectancy between the most and least affluent areas of the country. Less than a year ago, the Government promised to tackle the causes and symptoms of these underlying health inequalities and publish a White Paper on health inequalities. Last month, the Department of Health and Social Care confirmed that no White Paper would be published. I am pleased that today, Labour announced that we will build an NHS fit for the future and cut health inequalities.
The cost of living crisis has pushed over two thirds of UK households into fuel poverty, which will exacerbate health inequalities that were already widened during the pandemic. In September 2022, one in four households with children experienced food insecurity, and in my constituency of Jarrow, 39% of children are living in food poverty. Malnutrition costs the NHS an estimated £19.6 billion each year. Investment in greater support, particularly targeted at the most vulnerable, would lead to returns in reduced NHS demand. As well as a strategy for the NHS, this Government need to start prioritising much more support to get the most vulnerable through the cost of living crisis. I hope Ministers will listen closely to the contributions in the debate and take on board what is needed for a workforce strategy and funding to secure the future of our NHS.

Matthew Hancock: I rise to set out in this debate on the future of the NHS, with the experience of three years as Health Secretary, how we can build on the promise of healthcare that is free at the point of delivery for every single person in the United Kingdom. This is a promise that I hold dear in my heart and that my party has supported with enthusiasm throughout the NHS’s over 70-year history. In fact, the NHS has been run by Conservative-led Administrations for the majority of its time.
It is a joy to follow the hon. Member for Jarrow (Kate Osborne). A few of her comments were not quite right, but I can tell from what she said that she, like me and like the vast majority in this House, supports the principle of an NHS that is free at the point of use. As a Conservative, there are many reasons why I believe in that so strongly. I will set aside and not make the straight- forward political argument that no party in this country would ever get elected to power without steadfast support for the NHS. As Nigel Lawson put it, the NHS is the closest thing we have to a national religion, and that captures it about as well as we can. Over 75% of the public believe that the NHS is crucial to British society.
However, there are substantive reasons, as well as those purely political ones. The first is the importance of the efficiency and effectiveness of the delivery of healthcare—the nuts and bolts of why it is good to have  a free-at-the-point-of-use healthcare system. According to 2019 figures, just before the pandemic, the proportion of GDP that we spent on healthcare in this country was just over 10%. In the United States, it is over 16%. In Germany and France, it is higher too, yet life expectancy is higher in the United Kingdom, showing that we deliver more effective healthcare, and a lot of that is because it is a universal service delivered free at the point of use.
The second argument, which is quite an unusual one that is not often made but is important especially to those whose heart beats to the right, is a pro-enterprise, pro-business one. Enterprise is the source of prosperity for any nation; a quick look at the history books demonstrates that that is where our prosperity comes from. We can start a business in the UK and employ somebody in the private sector without having to pay for healthcare, whereas in many countries around the world, one of the first costs for a new or growing business is healthcare for its employees. That is not necessary here. There is a pro-trade, pro-business argument for having an NHS free at the point of use.
Thirdly, there is the moral argument for having a universal healthcare system. It is impossible for any of us to know when we will need healthcare—it is impossible to know when we might have a condition or an accident that means we need healthcare. The NHS means that we, metaphorically, sit by each other’s bedsides and support each other in our hour of greatest need. That is why the public’s connection to the NHS, and certainly my connection to the NHS, is not just a question of policy; it is a deeply emotional connection. We are in the NHS at some of the best times in our life, such as when children are born, and some of the worst times in our life too. That provision being there for us when it really counts means that there is a moral case for universal healthcare provision, free at the point of use, that I hold dear too.

Jeremy Corbyn: I absolutely agree that there is a moral case for healthcare free at  the point of need in our country—I absolutely support that. Does the right hon. Gentleman not think, though, that there is something immoral about the huge profits that are being made out of the NHS by private contractors that have been brought into it, when those profits that are paid to shareholders all over the world in the form of dividends would be better invested in the healthcare of people in this country?

Matthew Hancock: I am very grateful to the right hon. Member for that intervention. I am not surprised that he agrees with what I said about the moral case for a universal healthcare system, nor that he makes the case against any use of profit in the NHS. I was going to come on to exactly that point, because it is bunkum to suggest that the NHS has ever in its history provided services without the use of private companies. That has happened throughout the long and proud history of the NHS, and it is absolutely vital to its functioning—always has been, always will be, under Governments of all stripes. I will come on to explain why.

Geoffrey Clifton-Brown: My right hon. Friend is being generous with his time. Is there not a fourth argument for a universal healthcare system, which my right hon. Friend was very keen on  when he was Secretary of State: the ability to introduce new technologies, new procedures and new drugs? All of those things are much easier when one has a big bulk of patients to draw data from.

Matthew Hancock: Two of my arguments for what the NHS needs to do better in the future are responses to precisely the two points that have just been made. I cannot decide which order to go in, but both are absolutely vital. I agree with my hon. Friend, and disagree with the right hon. Member for Islington North (Jeremy Corbyn).
Given the pressures on the NHS, in order for it to succeed in the future, all of us who care about the NHS must have a hard-headed view of what needs to happen for it to function long into the future. One of those things, which I think is absolutely central, is the use of technology, so I will come to that point first. Today, the NHS has more clinicians in it than ever before. Contrary to what the hon. Member for Jarrow said, it has a higher budget than ever before. It has more nurses and more doctors than ever before, it is delivering more service than ever before, and it takes up a higher proportion of our national income than ever before. That has all happened under a Conservative Government that believes in the NHS. Those are the facts.

Alex Cunningham: I am sure the right hon. Member will acknowledge that a lot of the doctors who are now working in the NHS were trained under a Labour Government, with the Conservative Government now getting the credit for them. Since then, we have seen a reduction in the number of doctors trained.

Matthew Hancock: No, that is not right. There are record numbers in training, and the opening of the new medical schools that were put in place by my right hon. Friend who is now Chancellor of the Exchequer is another Conservative achievement in that space.
However, given the record numbers of nurses and doctors, the record numbers of training places, the record numbers of GPs coming out of training places and the record funds going into the NHS, there is still a record-scale problem. I do not at all deny the scale of the challenge, but that challenge demonstrates to me the vital importance of reform of the NHS—we cannot support its long-term future without supporting reform. My experience of the NHS and of being Health Secretary tells me that the single most important thing that has to happen for the NHS to be as effective as possible in the future is the widespread and effective adoption of the use of technology and data, so that the NHS can be more efficient, giving clinicians back—as Eric Topol put it when he launched his review in 2019—“the gift of time”.
The inefficiency of the NHS because of poor use of data leads to appointment letters being sent out that arrive after the appointment date has passed. Who gets a letter these days for an appointment, anyway? We all use modern technology instead.

Florence Eshalomi: Will the right hon. Member give way?

Matthew Hancock: I will in a moment.
That inefficiency means that different parts of the NHS cannot talk to each other, and indeed cannot talk to social care. It means that a person can end up going into hospital for a serious procedure, but their GP will not know that they have had that procedure, because they went in urgently rather than through that GP. It means that there are people right now who go into an NHS hospital and find that their records, which are on paper, cannot be adequately analysed. Service provision is worse as a result, which directly impacts people’s health. The poor use of data is the No. 1 factor holding back the effective use of the resources that we put into the NHS—not only the cash but, crucially, the staff. They find it deeply frustrating that they have to work with these terrible IT systems when every other organisation of any scale in this country, or in any developed part of the world, uses data in a much more efficient, effective and safe way.

Alex Cunningham: Will the right hon. Gentleman give way?

Matthew Hancock: I will make one final point before I give way to the two hon. Members who are seeking to intervene, which is that the inefficiency in the NHS is best exemplified by its ridiculous continued use of fax machines. Those machines are totally inefficient and completely out of date, and are also terrible for privacy and data protection, because one never knows who is going to be walking past the fax machine. When the Minister sums up, I would like him to set out what he is doing to not just get rid of those fax machines—I tried to do it and made some progress, but did not manage to finish the job—but, more importantly, drive the use of high-quality data, data analytics and digital systems throughout the NHS. Investment in that is the single best way to ensure that all patients can get the service that they need.

Florence Eshalomi: To bring the right hon. Member back to the point he made about digital data and making sure that patients are accessing services, I hope he will agree that for a number of my constituents, and probably his constituents as well, access to the internet is a luxury that they cannot afford. A number of people I represent cannot afford a monthly broadband connection because they are choosing between heating their home and paying their rent. They do not have monthly broadband, so they cannot log on to book online appointments; they want to see a GP, but they cannot.

Matthew Hancock: Of course, it is critical that people do not have to use a computer to access a universal service. Many people will never use a computer in their lives, but the fact of the matter is that well over 95% of us use technology every single day. We can get enormous gains through the use of technology, which allow us to give better provision to the tiny minority of people who do not use technology. The point that the hon. Lady makes is absolutely valid, but it is no argument for not using data and digital services effectively. On the contrary, we can make it easier for the very small minority of people who cannot, will not or cannot afford to use digital technology by using data more effectively for the rest of us.
One example that shows this can be done is the vaccination programme, which was built on a high-quality data architecture. People could book their appointment, choosing where and when to get vaccinated—where else  in the NHS could they do that? They should be able to do it everywhere in the NHS. Hardly anybody waited more than 10 minutes for their appointment; it was one of the most effective and largest roll-outs of a programme in the history of civilian government in this country, and we started with the data architecture. We brought in the brilliant Doug Gurr, who previously ran Amazon UK, to audit it and make sure that it was being put together in a modern, dynamic, forward-looking way. It was brilliant, so anybody who says that data cannot be used more effectively is fighting against history.
Of course, a tiny minority of people did not use the IT system to get vaccinated. That was absolutely fine, because that high-quality data system meant that everybody else could, leaving resources free for people who either needed to be phoned or needed a home visit in order to get the vaccine.

Margaret Greenwood: The right hon. Member is being very generous with his time. We all believe that technology is useful, and we all embrace it—of course we do—but data is a different issue, because in situations where both the NHS and the private sector are providing services, people get understandably nervous about their data being shared.
The issue I wanted to raise with the right hon. Member, which follows on from the point made by my hon. Friend the Member for Vauxhall (Florence Eshalomi), is the percentage of people who do not want to access things through the internet. I had a retired nurse come to see me, saying that she found eConsult—the system for booking a doctor’s appointment—incredibly difficult to use. She was not speaking just for herself; she was worried that many of her friends were no longer going to the doctor because they could not use eConsult. I also remind the right hon. Member that 7 million adults in this country are functionally illiterate, so having a system that is overly reliant on such methods is not going to serve the whole population.

Matthew Hancock: Of course, if somebody cannot use eConsult, they should be able to phone up or turn up in person, but that does not take away from the fact that there will be more resources to help those people if the existing resources are used effectively, because the vast majority of people use modern technology for so much of their lives. The arguments that we have just heard are arguments for ensuring that there is also provision for the small minority who do not use data and technology, as demonstrated by the vaccine programme, where a tiny minority of people did not use technology but the vast majority did.
We require high-quality privacy for data in many different parts of our lives—for example, financial information. Whether in the public or private sector, privacy is vital, and the General Data Protection Regulation is in place to set out the framework around that. That is an argument not against the use of data, but in favour of the high-quality use of data. Health data, financial data and employment data are all sensitive and personal pieces of information. The argument that we should not use data because of privacy concerns is completely out of date and should go the same way as the fax machine.

Alex Cunningham: I am grateful to the right hon. Member for giving way for a second time. It seems to be a common theme for former Health and Social Care  Secretaries to come and tell us about the litany of failures in the national health service and offer some solutions. I am interested to know which of those failures he takes personal responsibility for.

Matthew Hancock: I wish that I had been able to drive forward the use of technology even more than I did. I pushed it as hard as I could, but if I could have gone further, I would. It is about not just efficiency for the health service, but a better service for patients and the research agenda. Another advantage of a universal service is that, because almost everybody in the country is within the NHS system, we can do amazing research to find out what treatments work better. If we can get high-quality data into the hands of researchers, they can discover new drugs or new procedures to save lives.
Yesterday, for instance, I signed up and had my bloods taken for Our Future Health, which is a wonderful programme run by Sir John Bell that aims to sign up 5 million people—ill and healthy—to give, with consent, their health data and blood to a large-scale research programme to find out what keeps people healthy. That is for 5 million people, but we can use the NHS effectively —with proper consent and privacy—to save future lives, which is yet another benefit of a universal healthcare system.
My second point—I will make three—on what the NHS needs to do more of in the future is about efficiency. The Prime Minister was right in the summer to float the idea that if someone misses too many appointments without good reason, they should be charged for  them. One of the problems for efficiency is that many appointments are missed, which wastes clinicians’ time. It was right to consider that idea, but I would be totally against people having to pay for the first appointment.

Geoffrey Clifton-Brown: I am grateful to my right hon. Friend for giving way again. I had to have a procedure the other day that I imagine cost the NHS quite a lot of money. When I was talking to the consultant, she told me that some days, she had a 50% no-show rate, which must cost the NHS several thousand pounds.

Matthew Hancock: I hear such stories all the time. We should separate out free at the point of use from not abusing the service. Of course, people miss appointments for good reasons, but too often they do not have a reason. We should be thoughtful about how we address that.
On the point of the right hon. Member for Islington North about the use of the private sector, the NHS has bought things from the private sector throughout its entire life. Who built those fax machines? It was not the NHS. The NHS buys stuff—everything from basic equipment to external services. GP contracts are not employment contracts but contracts with a private organisation. Most of those private organisations are not for profit; nevertheless, they are private organisations and always have been.
The previous Labour Government expanded the use of the private sector, of course, to deliver a free-at-the-point-of-use service. Patients, in large part, do not care whether they get their service from the local Nuffield or the local NHS—it does not matter. What matters is that they get a high-quality service at the right time and as quickly as possible.
I was delighted that the shadow Secretary of State for Health and Social Care, the hon. Member for Ilford North (Wes Streeting), recently set out that Labour’s policy would return from what I regard as a totally impossible, mad, hard-left agenda of saying that we should not have the private sector in the NHS—even though it has always been there and always will be—to the position that Labour held when it was last in office and used the private sector for the delivery of services where that was in the best interest of taxpayers’ money and patient outcomes. That has been done over and over again, and that contracting is important.
To be in favour of the NHS being free at the point of use, and to be against NHS privatisation, does not rule out the NHS delivering services as effectively as possible whether through employing people or using contracts. The nature of the delivery is secondary to the importance of it being free for us all to use, for the reasons that I have set out.

Margaret Greenwood: Will the right hon. Member give way?

Matthew Hancock: I will give way for the final time.

Margaret Greenwood: The right hon. Member is being generous. I completely disagree with him about charging people for missing appointments. I remind him that 7 million adults in this country are functionally illiterate and huge numbers of people have dementia, so if a letter comes through the door, they may not understand it. Does he not agree that it would be much better to put resources into understanding why people do not come to appointments?

Rosie Winterton: Order. The right hon. Gentleman has been generous in taking interventions, but I am conscious that there are quite a lot of speakers, and if everybody takes nearly half an hour, we will not get everybody in.

Matthew Hancock: I apologise; I have tried to be generous in taking interventions. It has been a positive and good-natured debate, which is valuable. I entirely recognise the point made by the hon. Member for Wirral West (Margaret Greenwood), and it has to be done sensitively, but the point made by my hon. Friend the Member for The Cotswolds (Sir Geoffrey Clifton-Brown) about the sheer quantity of missed appointments is a problem that must be resolved.
My final point is that too often, the NHS is a national hospital service that fixes people after they get ill—that happens in this country far more than elsewhere. The effective prevention of ill health is central to ensure that the NHS can continue to thrive in decades to come. The gap across the country is huge and it needs to be addressed. For example, the gap between the life expectancy of 74 years for a man in Blackpool and 81 years for a man in Buckinghamshire is far too high. About half that gap, however, can be put down to the difference in smoking rates—it is not about the NHS service in Blackpool at all, which is excellent.
We have to support people to prevent ill health in the first place; hitherto, the NHS has not put nearly enough effort and attention into that. I hope that the Minister will confirm the importance of prevention. I know that  the Select Committee is about to launch an inquiry into prevention policy. I was delighted to set up the National Academy for Social Prescribing when I was the Secretary of State to try to drive the agenda further, but there is clearly much more to do.
The NHS is our national treasure. For those of us who care deeply about a service that is free when people need it, where the nation collectively comes together to look after those who are ill, it has deep moral force and is efficient and effective. If people care about its future, however, we need to reform it and ensure that we bring it into the modern age—only then can that promise to the nation continue to be fulfilled for the rest of our lives.

Liz Twist: First, I congratulate my hon. Friend the Member for Jarrow (Kate Osborne), my constituency neighbour, on securing this debate, which is hugely important. I listened to the former Secretary of State for Health, the right hon. Member for West Suffolk (Matt Hancock), speaking about data and so forth, and there are clear points there, but I want to focus on the experience that my constituents, my family and my friends have of the NHS. Let me declare an interest in this debate as a Unison member and a former Unison health representative, which I am glad to say hugely informs my interactions on this subject.
There has never been a more urgent need to talk about our NHS. All of us from across the House regularly attend drop-ins with cancer charities and other medical charities, and they tell us about the situations that they face and the backlogs. We all make arguments about those things, but we cannot just see them in isolation: we cannot look just at cancer figures or mental health figures; we need to look at the NHS as a whole system and at how we can make it better.
I want to refer to some of the figures after 13 years of Tory Government. We know that satisfaction with the NHS is at a 25-year low of 36%. That is a drop from 70% in 2010, when Labour left government. Some 7.2 million people are waiting to start planned NHS treatment, which is nearly three times the figure when Labour left power. Before the pandemic, the number was already 4.6 million, so this is not just a covid-related issue, though covid clearly made things difficult—the figure was increasing anyway. Just 80% of patients with an urgent GP referral for suspected cancer saw a specialist within two weeks, which means that more than 42,000 people wait too long.

Florence Eshalomi: I thank my hon. Friend for making such a powerful speech, and I declare that I am also a proud member of Unison. Cancer Research UK recently held a drop-in session in Portcullis House, and I must say I was quite surprised to see the statistics for my constituency. We have a world-class hospital quite close to a world-class cancer treatment centre, but even in my constituency of Vauxhall over 300 people have missed the 14-day window and have been waiting longer. Does she not think that this is a big issue right across the country and something the Government need to get a grip on?

Liz Twist: I most certainly agree that that is a shocking figure. We need to make sure that we are really addressing all those issues very urgently. Those cancer waits are  really important for what happens when undertaking treatment and the possibility of cure, so we really need to get on top of that.
When we look at accident and emergency, which has been much in the news, we see that 11,000 patients died after waiting more than 11 hours in A&E in 2021-22. The Government have just changed the target to 76% of patients waiting less than four hours in A&E by March next year, but we really need to return to the original target. Just changing the figures does not mean that people get better or that fewer people die; it means that the figures have been changed, and people understand that. My constituents know that.
More than 1.5 million people are waiting for key diagnostic tests such as MRIs, which is an increase of 95,500 from this time last year, whereas in May 2010 just 536,262—actually, that still sounds like a big figure—were waiting for key diagnostic tests. We need to get better, not worse, at doing these things.
One in seven people cannot get a GP appointment when they try to do so. All of us know, as constituency MPs, that one of the issues people consistently raise with us is that they are unable to get appointments in a timely fashion, so something that needs seeing to now is perhaps only seen to in a few weeks’ time. That is despite the really heroic efforts by a lot of our GP practices and surgeries, and the staff working in them, to try to make sure that people can get the advice they need when they need it. We know there is a shortage of GPs. Just in my constituency, people talk to me about that regularly. I regularly discuss with the NHS and with the new integrated care boards what is happening in that area, and things are really difficult for us at the moment.
At the same time, there are huge numbers of nursing vacancies in the NHS, with 47,000 posts unfilled, according to the latest figures. Some 40,000 nurses and 20,000 doctors left the NHS in the past year, and only 7,000 of those people retired. Surely, we must agree that patients need care and the NHS needs staff, and that it must be a priority to resolve this situation. That is why I am so pleased to see that Labour has a plan to address those workforce issues, because those workforce issues are at the heart of the difficulties within our NHS. It is not problems with NHS staff or that people are not working hard; they are working hard and, if anything, really becoming burnt out.

Rob Roberts: I am delighted to hear that Labour has a plan. Would the hon. Lady please share it with the Health Minister in Wales? If Labour has a plan, it would be really good to have it in Wales, where Labour does not seem to have one at all.

Liz Twist: Well, I thank the hon. Member for that comment, but I will stick to my constituency in the north-east, if he does not mind.
As I was saying, this is not an issue with the staff themselves. The staff are working really hard and really down to the bone, and that is leading to the situation being made worse with people leaving or taking retirement. All of us will have friends and family who work in the NHS—certainly in the north-east, we have a huge number of people working in the NHS—and we see the strain on them, and on their faces, as they try to cope and deal with the issues they see day in and day out, so it is really important to address that.

Alex Cunningham: My hon. Friend and I were in a meeting earlier this week with the regional care board, and it told us that, in the north-east, we actually perform a little bit better on elective care. However, it also told us that the growth we can expect in the north of England is going to be much smaller than elsewhere in the country. Does that concern my hon. Friend as it does me?

Liz Twist: That certainly concerns me and, yes, my hon. Friend is absolutely right to say that. Actually, I would say that in the north-east we have really good and positive acute services, which are the ones he is talking about, thanks to the hard work of so many people, but what we lack is the preventive work and the work to avoid people becoming ill in the first place. We have the lower life expectancy and the health inequalities that my hon. Friend the Member for Jarrow talked about, so it is important to our people that we do that.
I was interested to hear the comments of the right hon. Member for West Suffolk on health inequalities. He is right to identify them, but what the Government have done is reduce the amount available to public health to address those issues before they develop. It is great that we have good hospitals and good-quality services, although they are really under pressure, but unless we address those public health issues and fund public health services, we are not going to tackle some of those issues.
The other aspect of that is social care. Once again, the Government have failed to tackle social care, and we know that one of the key things in tackling social care is getting people discharged from hospital, and getting them and supporting them to be independent at home. However, we really need a plan and to think some more about this. It may be a different Department—[Interruption.] No, it is the same Department now—sorry; my mistake—but we need to tackle that issue if we are going to make real progress.
I want to talk a little about mental health services. Many Members will know that I chair the all-party parliamentary group on suicide and self-harm prevention. We see the impact of a whole range of different policies, and the inability to access services. Too many mental health patients are forced to seek mental health treatment through emergency or crisis services. One in 10 ends up in A&E. We need to ensure adequate access to mental health services for both children and adults facing mental health crises.

Jeremy Corbyn: My hon. Friend makes an important point about isolation and mental health, particularly for teenage boys who, sadly, have the highest suicide rates. There has to be a reach-out and an understanding that overcrowding, poverty, bad housing and many other things contribute to mental health stress. It is not just a medical condition.

Liz Twist: It is absolutely right that socioeconomic factors have an impact on the number of suicides and lead people to suicide ideation. It is clear that mental health services for young people are struggling. People can be identified as having mental health problems, referred to child and adolescent mental health services and still not get the support they need for years. It is a difficult situation and something needs to be done. Mental health is an integral part of our NHS and needs to be dealt with effectively.

Paulette Hamilton: My hon. Friend raises a valuable point. I am passionate about mental health, but at the moment we have no plan. The 10-year plan for mental health services and the way forward was abolished and nothing has been put in its place. Does my hon. Friend feel that that has contributed to the fact that we are seeing so many issues in our young people and elderly, and anxiety in our teenagers?

Liz Twist: I most certainly agree that there is a need for a mental health strategy. I have spoken to voluntary organisations that work in the field such as YoungMinds, which is concerned that young people put a huge amount of effort into commenting on the proposed mental health strategy, but that has now been subsumed in the wider health strategy that the Government talked about just a few weeks ago. There are real concerns from not just YoungMinds but many quarters that the mental health strategy will be lost in a wider mix. I hope that the Government will listen to that. YoungMinds engaged a huge number of young people to talk about this issue, and those people feel that their views are not being considered.
There are so many things that I could talk about but I will not, you will be pleased to hear, Madam Deputy Speaker. I want to confirm that our NHS is hugely valued by my constituents and everyone in the country. We need to ensure that it works well and effectively and that we have the staff that we need. I hope the Government will look at the workforce plan, because that is key to many of the issues we face. My constituents need the NHS, and we need it to work properly. I am glad that Labour has plans to do that in future.

Geoffrey Clifton-Brown: I am delighted to catch your eye in this important debate, Madam Deputy Speaker. I commend the hon. Member for Jarrow (Kate Osborne) on having obtained it, and the hon. Member for Blaydon (Liz Twist) on the sincere way in which she made her points. I share one point of absolute agreement with her, which I will make in my speech: the health service cannot function without enough properly trained staff.
I listened to the speech from the former Secretary of State for Health, my right hon. Friend the Member for West Suffolk (Matt Hancock), with great care. I absolutely agree—I doubt a single Member of the House disagrees—that we all want forevermore a universal health service free at the point of delivery. I commend his arguments and agree why that should be.
The health service was dealt a terrible blow during covid and we need to catch up from that. Two-year waiting lists are falling, but we need to improve on 18-month waiting lists. According to data from September 2022, the overall number of people working full-time in the NHS increased by 2.7%, or 36,000 people, compared with the previous year—a point made by my right hon. Friend the Member for West Suffolk. However, there are 130,000 job vacancies, and we need to try to fill those. The latest data published by NHS Digital up to September shows that there are almost 4,000 more doctors and 9,300 more nurses working in the NHS compared with September 2021. But compared with 2015, we have 1,622 fewer fully qualified GPs today. We are seeing the consequences play out in the health service.
Working in healthcare can be very rewarding. However, for many working with staff shortages, it can be incredibly tiring and stressful. The care that they want to provide to all patients is not always possible, and talented individuals are pushed to leave for new opportunities. As well as pay, employment conditions are critical. That is particularly true in the social care sector. In my constituency, double the number of people are in hospital today, clinically fit to be discharged but not able to leave hospital because there are not enough social care workers. We need to look critically at how to bolster that social care system.
The recovery of the NHS is very important to many of my constituents in the Cotswolds, who regularly contact me with concerns about accessing the treatment they require in a timely manner. As I have said, waiting lists in January fell for the first time since the start of the pandemic. Elective care was delivered for 70,000 more patients in November compared with the same month before the pandemic, as the waiting list dropped by almost 30,000 compared with the previous month. However, there were around 7.2 million incomplete treatment pathways as of December 2022, with 406,000 people waiting more than a year for a consultant-led referral to treatment.
There is much work to be done to be caught up from the pandemic. We all know that there are problems in the NHS, but I do not think we have had anything like the pandemic since the second world war. Actually, the health service is to be hugely commended on what it did during the pandemic: the speed with which it was able to administer vaccines, the tremendous care that saved the lives of my constituents and those of every other Member of Parliament. That was to be wholly applauded.
The key to combating waiting times and revitalising the NHS is to recruit more staff, especially filling those frontline positions, and increasing retention. That will enable us to get greater flow through our healthcare system and reduce the waiting time for all treatments, including the critical cancer pathway. We urgently need to invest to train more doctors and nurses, instead of relying on recruiting talented people from poorer countries. It is no good Opposition Members crowing about the training that was provided when they were in office. I seem to remember when Tony Blair was Prime Minister that he shut some of the nurse training centres.
I think it might be of interest to the House that two weeks ago I went on a Public Accounts Committee visit to Denmark, to inform the Committee on the hospital construction programme that we are about to embark on in the UK and ongoing work on the Department of Health and Social Care. Some of the things that we discovered on that visit could be introduced into the health service, and some chime with what my right hon. Friend the Member for West Suffolk said.
Denmark faced many of the same issues as we do now: an ageing population, an ageing workforce within the healthcare system, increased chronic disease, workforce shortages and new needs for educating staff in the latest technology and ways of working. However, it has completely reformed its approach to healthcare in the past 15 years and created a model from which I believe we can learn a great deal. It has closed dozens of old hospitals and is in the process of building 16 brand-new hospitals. Most are completed and the remainder are scheduled to be finished within the next five years. Critically, it has  reduced the number of beds by 20%, instead opting for a policy of far greater out-patient treatment and treatment at home. Even quite complicated procedures, such as chemotherapy, are delivered in the home. GPs are absolutely the key to this system, and are described as the gatekeepers for the rest of their entire healthcare system. It was made clear that the policy decision, made in 2007, was not an easy one. They have faced significant cultural resistance from some residents who are now required to drive for up to an hour for care.
The overall vision was for patients to spend as little time in hospital as possible. Today in Denmark people spend an average of 3.5 days in hospital compared to six in the UK. The aim is to discharge people either to their home, or to the municipality nursing or residential homes, as quickly as possible. The system makes great use of telemedicine wherever possible. The increase in care was possible as the number of GPs within the healthcare system was increased by 50%.
Another important change in Denmark, which chimes with what my right hon. Friend the Member for West Suffolk said, was the health digital revolution. Ninety seven per cent of the population now have good broadband connections, and all citizens have a unique reference that covers a number of Government services, including tax and health. The whole healthcare system has been transformed into a digital and paperless system. Access to medical records is strictly controlled, but is available to the relevant physician treating the patient, with their consent. Those physicians update the records in real time. As my right hon. Friend said, appointments are made online through an app, eliminating a vast number of letters and phone calls.
Relevant to our building system for the 40 new hospitals is that the Danes have now produced a standardised hospital design. That was not easy, as different specialties have different requirements. For example, most Danish hospitals have introduced four different-sized but standardised theatres. There are no hospital wards; instead, all rooms are single, with their own bathroom and a bed for a relative to stay overnight or longer. That standardised design will enable hospitals to be built cheaper and more quickly, and it will eliminate the elementary problems that sometimes arise even when our hospitals are newly built.
As I have said, in the UK there is a pledge to build 40 new hospitals at an estimated cost of £1 billion each. While we have many similarities with the Danes—we are fortunate that we both enjoy a universal, equal and free healthcare system—the success of the Danish system comes from its ability to treat many patients outside of hospitals. In the UK, hospitals are often viewed as an inevitability for many people requiring treatment; in Denmark, they are the last resort. I believe there are some real lessons we could learn from the Danes. We need to do so, because it is clear that we cannot continue as we are.
Our health system is limping on, and the cost to the taxpayer is increasing. According to recent figures, £277 billion was spent on healthcare in 2021. That is 11.9% of our total GDP. Some people complain that this is out of kilter with other countries in the world. Certainly, health spending in the United States is 17.8% of GDP, but that is accomplished through both insurance and public finance. Our figure is comparable to the 12.8% of GDP spent in Germany, and the 10.8% spent in Denmark. Both the United Kingdom and Denmark  do not have enough doctors, nurses, and, in particular, social care workers. For a health service to run efficiently, it must have sufficient staff who are well motivated and trained.

Yasmin Qureshi: I thank my hon. Friend the Member for Jarrow (Kate Osborne) for securing this important discussion; a discussion that, after 13 years of Tory managed decline of our public services, is crucial. I declare an interest as the chair of the all-party parliamentary group for dentistry and oral health, and as a member of the all-party parliamentary group for whistleblowing.
We have heard discussion of various issues facing the NHS, and I know that many colleagues will talk further about them. I will focus on one aspect of the NHS that is not discussed so much: oral health and dentistry. When I was chosen as the chair of the APPG late last year, I said that I would focus on putting the mouth back in the body, and giving oral health parity with mental and physical health in our political discourse.
I start by asking Members to ponder what they think is the No. 1 cause of admissions to A&E for children. It is not broken bones, soft tissue damage or even respiratory diseases; it is tooth decay. We have children in hospital waiting rooms just so that they can be seen for tooth decay. I do not think any of us should stand by and watch that happen.
Let us assess the facts of the dentistry crisis. We have lost 40 million NHS dental appointments since the start of the pandemic, and NHS dentistry is in a wider crisis. The net amount that the Government spent on dentistry in England was cut by over a quarter between 2010 and 2020. We are losing dentists from the profession because they are taking early retirement or changing careers altogether.
I know that the Chair of the Health and Social Care Committee, the hon. Member for Winchester (Steve Brine), is conducting an inquiry into this, and I have already told him my views. We want the Government and the Minster to step up and support our NHS dental practices, and to ensure that patients can access them. I am pleased to see that the Minister responding today has dentistry as one of his responsibilities. I hope that he will be able to answer some questions about this issue. I give praise where praise is due: before Christmas, the Government tweaked the NHS contract to incentivise dentists to carry out complex care. That is a good, genuine starting point; but it is only a starting point.
What people do not seem to realise is that our oral healthcare is in fact connected to our general healthcare. For example, researchers at University College London have found links between severe gum infections and type 2 diabetes and cardiovascular illness. To not treat that properly and in time is not only a serious healthcare issue but is a false economy. We can and must support our NHS dentists to take a preventive approach to oral healthcare, so that in the long run we can save the NHS money and stop people’s suffering. The principle is the same with tooth decay in children; a routine check-up twice a year will save the NHS money in the long run, and at the same time get rid of pain and other problems.
We have a system in our country where some dentists are completely private, but a number of them are mixed practices. The problem we are having—and what does  not make sense—is that there are dentists who are not fulfilling their required units of dental activity as per the NHS dental contract, while at the same time offering private appointments on an early and more frequent basis. I will give an example. I was contacted by a constituent who was trying to get an appointment with an NHS dentist. I made six phone calls to dentists in my constituency who were supposed to be NHS dentists. I was unable to get a single appointment with any of them. Obviously, I did not tell them I was a Member of Parliament; I thought that was a fairer way of finding out what their response would be.
I know that this experience is not unique to Bolton; colleagues from across the House—and across the United Kingdom—will have had the same problem of constituents contacting them about being unable to get an NHS appointment. I know from speaking to the chief dental officer that many dentists are not fulfilling their contractual requirements, and are instead returning the NHS money. We need to stop this problem. We are told that one of the reasons dentists are doing it is that NHS work is so low paid that they have to finance their practice by doing private practice work. I recently spoke to some dentists and they said that the amount of money they receive has not changed much over the past 20 years. Perhaps we need to revisit dentists’ contracts and ensure that they are properly renumerated so that they do not have the incentive to return NHS appointments to the local commissioning group or the NHS.
The other group of people who have been completely forgotten include dental hygienists, dental therapists, orthodontists, dental technicians and many others who work alongside dentists to address oral health issues. At the moment, none of them is considered to be an NHS worker. They are employed by dentists, who set their contractual terms and conditions, which are not as good as those offered by the NHS. They need to be classified as NHS staff. Will the Minister meet me and an alliance of dental professionals to discuss that issue and what we can do to address it?
The second often overlooked issue is whistleblowing in the NHS. It remains the case that many people in the NHS—doctors, nurses and other professionals—talk about not only bad practices but bullying and harassment. However, the minute anybody raises an issue, their temporary contracts are not renewed and they are denied promotion and decent references. They are at a complete loss. When they try to take on NHS trusts, the trust bosses tell them, “We’ve got millions and millions of pounds in our legal funds. You are not going to be able to challenge us.” I have many friends in the medical profession, including nurses, and they have told me about what is happening. I know some who have actually been told, “If you take a case out against us, we have a bottomless pit of money.”
A recent letter in the BMJ said that the bullying and harassment that an NHS trust can inflict on a consultant are so extreme that life in the trust becomes unbearable. Even being proved right after an inquiry provides very little solace, as does anybody acknowledging what they have done wrong.
I ask the Department of Health and Social Care to consider the situation in Scotland, where a proper whistleblowing system has been set up by statutory law.  There is legislation and guidance, and proper procedures as to who to go to, as well as an external person to appeal to if people are not satisfied. These things are very important. Whenever we hear news about big scandals in hospitals, we discuss it in Parliament, including in this Chamber, but then everyone forgets about it. It is a real problem. We are talking about the future of the NHS, and that means that we also need to address what happens when things go wrong in the NHS.
I hope that in his response the Minister will address how we can ensure that people can access NHS dentists, how we can make dentistry a real part of oral health, and how oral health can become part of the NHS generally. It should have the same presence as other parts of our health system. Finally, I also hope he will address the issue of whistleblowing. We need to make sure that we have good staff and that we maintain their confidence, and we need a proper system to deal with that.

Rob Roberts: It is a pleasure to follow the hon. Member for Bolton South East (Yasmin Qureshi), and I congratulate the hon. Member for Jarrow (Kate Osborne) on securing a vital debate on a topic on which I believe we could spend hundreds of hours, rather than the few short ones available to us this afternoon. But we take what we’ve got and we make a start.
I had hoped that this would be a serious debate about solutions, but sadly it seems to have descended into the same finger-pointing blame game that we always get. We will come back to that later.
I declare an interest: my fiancé is a research nurse who until recently worked in the NHS but has now gone into private sector research. I told him to watch this afternoon’s debate. He said, as a senior research nurse and someone who worked on the AstraZeneca covid team, “Why? It’ll just be a load of politicians blaming each other and not actually addressing anything.”

Alex Cunningham: Thirteen years!

Yasmin Qureshi: You have been in power for 13 years!

Rob Roberts: How right he turned out to be. However, he is watching it, and my phone has not stopped receiving messages such as, “Don’t agree with that intervention from the Opposition”, and, interestingly, “Hancock is making sense!” in respect of my right hon. Friend the Member for West Suffolk (Matt Hancock). My fiancé is not by any stretch of the imagination a traditional Conservative voter, but he gets it—he understands.
On 5 July 1948, the NHS was founded under Labour Health Minister Aneurin Bevan, who built on the initial idea in the 1944 White Paper, “A National Health Service”, introduced by Conservative Health Secretary Henry Willink, which set out the need for a free and comprehensive healthcare service. Aneurin Bevan is rightly hailed as the father of the NHS, but it is the Conservative Minister years earlier who can arguably be called its grandfather. And as we are all aware, grandparents always treat the grandchildren a lot better than their parents do.
There are 40 MPs in this place from Wales, the home of Bevan, and 26 of them represent various Opposition parties, but there are zero here today to talk about health services and to defend the record not of the UK  Government over the past 13 years—right hon. and hon. Members have taken aim at them this afternoon—but of Labour’s control in Wales over the past 25 years.
In 1948, average life expectancy was about 68 years old; today it is almost 85. That is a 25% increase in lifespan. In 1948, hospitals had a couple of X-ray machines. CT scanners did not come into use until the 1970s, while MRI scanners appeared in 1984. Ultrasound, which was previously an instrument used to detect the flaws in the hulls of industrial ships, was first used for clinical purposes in Glasgow in 1956 due to a collaboration between an obstetrician and an engineer.
A new CT scanner sets us back £1 million to £2 million. An MRI takes up to £3 million, and ultrasounds a few hundred thousand each. Each hospital has multiple numbers of those machines. Drugs and treatment developments cost literally hundreds of billions globally every year. We are keeping people alive longer, diagnosing them with ever more expensive machinery and treating them with ever more expensive medication and devices. In 1948, the population of the UK was just under 50 million. Today it is almost 68 million—an increase of 36%.
My right hon. Friend the Member for West Suffolk talked about data earlier. I am no healthcare specialist or expert data scientist, and I do not in any way have all the answers, but I like to think that I have a reasonable amount of common sense, and my common sense tells me that, when 36% more people are living 25% longer and are being diagnosed by expensive machines and treated by a pharmaceutical industry that costs hundreds of billions, we cannot keep running things based on principles devised 75 years ago.
The main point I want to get across in my short contribution is one of openness and debate. I have sat and listened to right hon. and hon. Members in this debate and others over the years talking about various elements of the NHS in England. It is all a Conservative problem, they say. Tories are destroying the NHS, they say.

Alex Cunningham: Thirteen years!

Rob Roberts: They are saying it now—they cannot help themselves. It is endemic in their thinking, but it does not help. Where is shouting at me getting them? Nowhere at all.

Alex Cunningham: Look at the stats!

Rob Roberts: I invite them to come to Wales and view the conditions in the north Wales health board, where only 62% of buildings are operationally safe and where the hard-working staff, including friends and family of mine, are working in impossible conditions. In England, one in 20 people—5% of them—have been waiting more than a year on waiting lists. In Wales, the number is one in four—25%. The NHS in Wales performs worse in virtually every measurable area than the English equivalent. Labour Members are not shouting any more—how interesting. Currently, only 51% of red call patients are responded to within the target eight minutes. These are the second longest ambulance wait times ever. Only 23% of amber calls, which include strokes, were reached within 30 minutes.
The hon. Member for York Central (Rachael Maskell) mentioned dentistry in an intervention. Only 7% of dental practices in Wales are accepting new patients.  Where is the outrage? Where are the demands for better? For every one pound spent on healthcare in England, there is almost £1.20 available in Wales—it is not a money problem—but for markedly worse outcomes in all areas. Where is the outrage? Instead, the Leader of the Opposition, in a speech last year in Wales, described the Welsh Government as providing
“a blueprint for what Labour can do across the UK”.
Well, good luck to the rest of the UK if it chooses to install the right hon. and learned Gentleman into Downing Street next year on that basis.
I am not helping the discussion with these statistics at all. I am guilty of the very thing I always tell others not to do—to stop blaming people, stop trying to score silly political points, and stop wasting everybody’s time by saying that different Administrations are to blame. There is no prospect of an open debate on the actual issues—the real, fundamental problems—if all we focus on is finding blame. It is easy, it is lazy and it gets us nowhere.
The NHS across the United Kingdom is in difficulty. It is in difficulty in England, Scotland, Wales and Northern Ireland. It is not in difficulty for political reasons; it cannot be, because there are three very different Administrations running health services in all those parts of the UK, and the same problems occur in all of them. We need to ask why there is so much waste in the NHS and why there are nurses graduating from universities with degrees who—as the RCN agreed with me recently—cannot draw blood or insert a cannula into a vein. It is not their fault; as with everything, it is the systems that let them down—systems that mean that health boards across the UK spend hundreds of millions of pounds sending graduates on courses to learn the clinical skills that they were not taught on their degrees.
I commend the shadow Health Secretary for something he said recently. He said that he would be prepared to use private sector resources to bring down waiting lists faster. He asked the question: “How can I look someone in the eye as a prospective Health Secretary and tell them that I have a way to provide them with a better outcome, but my ideology is standing in the way of their recovery?” He was lambasted for that view from his side of the aisle but, while he and I will disagree about almost everything else, I have to say that my respect for him went up significantly with that intervention.
The NHS health boards across Wales are sending people to private facilities, which is costing hundreds of millions of pounds. I commend them, because it is all about outcomes. We get so caught up on process and procedure—on who does what, when—that we lose sight of the outcomes for people. One of my most hated phrases in politics is “political football”. It is used almost exclusively in discussions about the NHS, but the bottom line is that things such as the health service have to be run by political decisions; otherwise, who could be held accountable to the public? If we take decisions out of the hands of politicians, who should make them and how can they be held to account?

Florence Eshalomi: I thank the hon. Member for making—a speech. He says that this is a political issue. Does he agree, then, that his Government have failed politically by not getting around the table sooner to avert some of the strikes that we have seen up and down the country?

Rob Roberts: I thank the hon. Lady for her intervention. How easy would it have been to go out into the media and say, “We’re asking for a 20% pay increase, by the way” —which is what happened—and then to blame the Government for not coming to the table? When the Government are called to the table on such ludicrous terms—from my point of view; everyone will have their own opinion—why should they engage? Timing is everything; they are now getting around the table and are now doing it. To answer the hon. Lady, she has condemned the Government for not doing it sooner, so I am sure she will now praise the Government for taking the time to do it.
The same strikes have been announced in Wales, but what happened there? Would the hon. Lady also condemn the Welsh Government for not getting around the table and not negotiating in the right way? [Interruption.] It never happens, or it is very rare. It is easy for the Opposition to play the blame game. Where has it got them?

Kate Osborne: I fail to see how the hon. Member does not understand that these points are political. For 13 years, a Conservative Government have underfunded the NHS, which has led to over 7 million people on waiting lists and tens of thousands of vacancies. As for the trade unions, yes, the Government are now talking to the RCN, but when are they going talk to Unite, GMB and the other trade unions that represent NHS workers?

Rob Roberts: I thank the hon. Lady for her intervention, but I am so exasperated by this. We hear from the Opposition all the time that the NHS was properly funded by Labour in 2010, but as the King’s Fund and many others will tell us, NHS funding has increased in real terms since 2010.

Kate Osborne: indicated dissent.

Rob Roberts: It has—although if Opposition Members want to argue with the King’s Fund, that is fine. But if NHS funding was okay under Labour and has increased in real terms since then, how is it not okay now? I agree that it is not okay now, but that is because of all the reasons I have already mentioned: we are keeping people alive longer, and sicker, there are more of them, and it is more expensive to diagnose and treat them. They are not political issues.
To draw my remarks to a conclusion, I am not familiar with the machinations of how to go about these things, but it seems perfectly reasonable to have, finally, some kind of royal commission—some kind of massive public engagement exercise—on the future of health services in the United Kingdom. We must tackle it head-on. We must not be afraid to go wherever that debate takes us in search of better outcomes for people. I just wish we would keep in mind that we are here for people. We are here to serve them and give them the best outcomes we possibly can, not to get caught up in form and process, or dogma and ideology. We are trying to make people better. We have to do whatever we can to get to the root causes of the issue, because as my former NHS and now private sector nurse partner tells me all the time—I quote—“You could fix so much if you’d just stop politics getting in the bloody way.”

Rosie Winterton: Order. I call Paulette Hamilton.

Paulette Hamilton: I, too, congratulate my hon. Friend the Member for Jarrow (Kate Osborne) on securing this debate.
I worked in the NHS as a nurse for 25 years. I know at first hand how soul destroying it can be to work long hours with inadequate staffing and funding. I am also a mom, a sister, a wife and a grandmother. I know how worrying it can be when someone is ill and how helpless long waiting times can make families feel. I have also experienced that at first hand with the NHS in the last year. That worry is felt right at the heart of our communities, time and again. My constituents tell me they cannot get a GP appointment. In Erdington, Kingstanding and Castle Vale, and across the country, every morning at 8 am, thousands of people call their local GP surgery to get an appointment. One of my constituents rang up her local practice to get an appointment and was fifth in the queue. By the time she got to the front, there were no appointments left. She told me, “If you ring at one minute past eight, you’ll be on the phone for at least 40 minutes. You won’t get an appointment, because they’ve already gone.”
That is not a unique example. If one of my constituents cannot wait to see a GP and calls an ambulance because they think a loved one has had a heart attack or stroke, they can expect to wait 27 agonising minutes. In December, many waited for over an hour. In November, my husband had a stroke. The ambulance never came. In January, across the UK, more than 40,000 people waited over 12 hours for treatment once they had managed to get to an A&E department.
With healthcare staff reporting stress, poor mental health and that they are still living with the effects of the covid-19 pandemic, it is no wonder that 40,000 nurses and 20,000 doctors left their jobs last year. Only 7,000 actually retired from their profession, so where did the other 53,000 go?
Let us be very clear: the NHS is on its knees. People in my community and across the UK are tired of empty promises from the Government when they know things are not improving. They know as well as I do that the NHS deserves better. People want to be heard. They want to feel like the people responsible for the services are listening to what they are saying and not just leaving the room. From GP practices in Erdington to hospitals and social care settings across the country, one thing is clear: only a Labour Government can fix this mess.

Rob Roberts: On a point of order, Madam Deputy Speaker. I apologise to the House for interrupting the debate. At the end of my speech, I may have used a little bit of intemperate language, which was not necessarily in best keeping with the traditions of the House. I apologise to you, Madam Deputy Speaker, and to the House.

Rosie Winterton: I thank the hon. Gentleman for his apology. As he said, it is important that we use moderation in our language.

Christopher Chope: It is a great pleasure to follow the hon. Member for Birmingham, Erdington (Mrs Hamilton) and to congratulate the hon. Member for Jarrow (Kate Osborne), who introduced the debate. She is from the north-east and I represent a  constituency in the south of England, but many of the issues that have been raised are common right across England.
I will begin by referring to today’s report in The Times of the recent survey by the Health Foundation. The report’s headline is, “Public’s faith in the NHS sinks to lowest level in two decades”. That is obviously a good reason for us to have this debate; we cannot have a situation in which the public’s faith in the national health service is so low and declining.
Only 33% of adult respondents to that survey said that they thought the NHS was providing a good service. That is down from 43% in May last year and 66% in 2012. Only 8% of people believe that Ministers are following the right policies. That view is not confined to people who are not natural Conservatives; only 24% of Conservative voters believe that Ministers are following the right policies. I hope that my hon. Friend the Minister, when he responds to the debate, will give some hope to those disillusioned Conservative voters that the Government will restore confidence in the health service by introducing the right policies.
Similarly, there are concerns about the standard of general practitioner care. Some 47% of people said it was worse than 12 months ago, and only 9% said that it was better. That figure is very low compared with historical records. Then we have the consequences of ill health being borne out by information that, of the 3.5 million people in the 50 to 69 age range who were economically inactive in the last quarter of 2022, 1.6 million reported ill health as the main reason for their inactivity, and another 155,000 reported ill health as an additional factor. We are talking not just about the circumstances of people not being able to get the help that they need from the health service at the time that they need it, but about the consequences for our economy of those people not being able to get to work when they would wish so to do.
The latest figures that I have are that there are still 406,000 patients who have been waiting over a year to start treatment. Many of them will be either unable to work full time or unable to work at all as a result. On the other side of the equation, 53% of people think that the health service often wastes money, only 4% believe that it never wastes any money, and only 33% believe it is generally efficient. We do indeed have a crisis on our hands, and I think it ill behoves the Government not to face up to these realities.
Probably like lots of hon. Members, I have received a mass of suggestions from constituents for how things might be improved. One, which came in a long letter from a leading member of the nursing profession, is that we made a mistake in 2009 when we made the nursing profession a fully graduate profession, with the result that someone cannot become a nurse unless they get a degree. They cannot even get a nursing apprenticeship, because that has to be linked to getting a degree.
I have heard from people who have been in hospital recently that some of the most caring people that they had looking after them were nurses who were not graduates, but people who decided to go into the profession some time ago—obviously they are now in the older age group—to look after their fellow citizens. Why did we have to make nursing a graduate-entry-only profession? Of course, that has enabled the profession to become more of a closed shop and to use some of its increased bargaining power in recent salary and wage negotiations.

Rachael Maskell: I am listening carefully to the point that the hon. Gentleman is making. The knowledge and skills framework was introduced in 2004 as part of the “Agenda for Change” package, but the Government have not invested in the opportunity that the framework provides to do the very thing that he suggests—to enable people to climb the skills escalator and move through their profession into higher roles. Does he agree that we need to make that investment so that we are using the skills that are already in the NHS?

Christopher Chope: The hon. Lady makes a very good point, and I am glad that I gave way to her to enable her to make it. We must do everything possible to increase the size and quality of the workforce and enable people who are already in it to improve their qualifications and progress through their chosen profession.
Constituents also tell me that there is a problem with retention. When nurses retire, they are expected to continue with continuous professional development; if they do not do that and fill in a lot of bureaucratic forms, they become ineligible to return to nursing later on. One of my constituents contrasted the situation in our country with that in the United States, where there are not so many bureaucratic barriers to someone’s carrying on nursing after they have retired, perhaps temporarily. I raised that point with the Government, thinking that it was a really good idea and that they should be getting to grips with it, but their answers to my questions suggested that it was not really on their radar and they were not interested in investigating it. Their response was, “We have a graduate-based profession, we have a retention scheme that we are not interested in changing, and the register will stay as it is.” I thought that that was a remarkably complacent response to what I considered to be quite a constructive suggestion from a qualified nurse.
Many people have made the point that we are training nurses and doctors at great public expense, and they then leave the profession and the national health service before they have paid back their dues. Again, there is a big contrast between what happens here and what happens in the United States. I am not saying that help with people’s development as they go through university should be conditional on their being forced to work for a particular employer or for the NHS when they graduate, but I do think there should be a system similar to the one in the United States, whereby those who are not going to work for the NHS are expected to pay back some of the costs of their training. There is a great deal of talk in this country about increasing the number of doctors and nurses, and the newspapers today refer to the need to increase the number of graduates, but that is not much use if so many of those graduates do not provide their services to the NHS.

Alex Cunningham: The same problem applies to dentists, who have no responsibility whatsoever to work for the NHS when they finish their training, which, of course, is funded by the state. Perhaps the hon. Gentleman would encourage Ministers to look at some form of requirement for them to work in the NHS at least for some time, which might shorten the waiting list for my constituents.

Christopher Chope: That, too, is a good point. I am not saying that the hon. Gentleman has necessarily got the right answer, but the Government should be looking at this. I listened with interest to the earlier references to NHS dentistry. In my constituency, there are a fair number of NHS dentists who would like to take on more patients, but the rules require them not to exceed 110% of their quota. Some of them are saying, “I would love to take on more patients,” but they are being told by the local bureaucrats that if they do so, they will suffer financial penalties.

Alex Cunningham: One of the main problems with dentistry when it comes to resources is the difference between the unit prices that dentists receive for their work. One practice in my area has two parts, each of which is paid a different rate per unit from the other, and it is much lower than that paid in some other parts of the country. Does the hon. Gentleman agree that the Government need to look at the fee structure and make sure that dentists are being properly paid to work in the community?

Christopher Chope: In fairness to the Government, they say that they are now looking at it—a bit late in the day, I think; a review should have been instituted much earlier—but the hon. Gentleman is right. It is ridiculous to have a structure in NHS dentistry in which the rewards are linked to the number of specific procedures that have been carried out. Each procedure is given a different rating, and then they are all added up to establish whether the total exceeds the permitted 110% capacity. That is another case of there being plenty of scope for reform and fresh thinking, but it seems to be almost a culture in the NHS not to be receptive to such ideas.

Rob Roberts: May I take up my hon. Friend’s point about dentists not taking on more work? The same applies to NHS doctors, who are subject to punitive measures involving their pension schemes. If they take on extra work or responsibilities, they receive huge pension bills—tens of thousands of pounds a year. Does my hon. Friend agree that a simple way of fixing a very simple problem would be to get rid of the annual allowance tax charge on the NHS defined-benefit scheme so that doctors could take on more work and reduce the waiting lists?

Christopher Chope: I do agree with that. I have raised this subject in parliamentary questions, and what have I had in return? Complacency and inactivity, and generalisations such as, “We realise that there is a problem and we must try to do something about it.” As a matter of fact, I do not think that this problem is confined to doctors; I think there is a much bigger problem relating to pensions, but that is a subject for another day.
Then there is the issue of productivity—or rather the lack of productivity—in the NHS. As we have heard, although the number of staff is increasing, output is not going up; in fact, it is falling. The Government again seem to be refusing to face up to these problems. Last April, NHS England carried out an internal review of productivity issues, which was referred to by the National Audit Office in its report on the subject in  November. I submitted a parliamentary question asking for the NHS England report to be published, and I had to wait weeks for an answer. On 22 December, I was informed by the Minister for Health and Secondary Care, the hon. Member for Colchester (Will Quince), that the publication of information about NHS England productivity available to the National Audit Office
“could prejudice the conduct of public affairs.”
I was amazed to receive such an answer, because surely we are the public. We are speaking on behalf of the public. Why and how could withholding from us an internal review carried out by NHS England be prejudicial to the conduct of public affairs, and how could it be prejudicial if it had already been seen by the National Audit Office?
I tabled another parliamentary question on 9 January, asking in what way the publication would prejudice the conduct of public affairs. One might have assumed that there would be a quick answer to that, because the Department must have thought about it when the first answer was approved by a Minister, but I had to wait until 20 February. In other words, I had to wait for about six weeks, until more than a month after the question should have been answered. The Minister replied:
“This report”—
the internal NHS England report—
“is currently being used by National Audit office and NHS England to inform internal policy for public services. To share this information would inhibit the open, free and frank discussions that are being had on these internal policies.”
I think that those “internal policies” should now be discussed openly in this Chamber. My message to the Government is that they need to get their act together in a way that they have not done hitherto, and address these serious issues.

Jeremy Corbyn: I thank the hon. Member for Jarrow (Kate Osborne) for initiating a debate that enables us to discuss the real philosophy behind the national health service.
When Aneurin Bevan piloted the original NHS legislation through the House, he was inspired by the way in which those in the community of Tredegar supported each other. In many ways, our NHS owes as much to the mining community in south Wales as it does to anyone else, in the sense that that was a community providing for each and every person, irrespective of their ability to pay but absolutely cognisant of their needs. That, surely, has to be the principle behind the national health service. There has been a little bit of rewriting of history today; just for the record, the Conservative party opposed the foundation of the NHS in 1947. It is on the record. It is in Hansard. No one can rewrite that.
We must also recognise that on his mission to establish the NHS, Nye Bevan was forced to make a number of compromises, the biggest of which was over the GP contract idea. The then BMA, which has thankfully mended its ways and is now very much part and parcel of the trade union movement within the NHS, opposed the NHS and threatened not to take part in it at all, hence the contractual arrangement that GPs have. In a sense, it is that contractual arrangement that is a fundamental problem within the NHS, and it affects not just GPs, but many others as well. There has been a discussion about dentistry today. Surely, many other  countries do not have this problem; they see a doctor as an important part of the health service, as we all do, and therefore we should employ them on a salary to be a doctor within the NHS. There are a small number of places around the country that have salaried GPs. I had one such practice in my constituency and it worked absolutely fine, until this Government interfered and handed it over to an American healthcare company, which, fortunately, has now been sent on its way, and the practice is now out for tender once again.
The original provision of the NHS was total healthcare, including preventive healthcare, such as optical treatment and dentistry. That was taken out of the NHS only two years later, and the prescription charges came in at the same time. As many have said today, we need to look at dental costs. Even within the NHS, they are so huge for many of our constituents that they either suffer the pain or borrow huge amounts of money to get private dentistry just to be able to get through the pain barrier that comes from not being able to get treatment. That is not acceptable. It is actually very expensive not just for the individual, but for our health service as a whole. We need to think a bit more about revisiting the totality of our national health service.
The undermining of the NHS went on for quite a long time. It reached its zenith, if you like, with the Health and Social Care Act 2012, which was piloted through by the coalition Government. That built on previous internal market ideas and specifically encouraged the contracting out of services, which are making a great deal of money through pharmacies in hospitals, through private finance initiatives in hospital and through a whole lot of other things. Money is being taken out of healthcare and handed over as private profit, which is why I intervened on the former Health and Social Care Secretary on this issue.
If we run the health service on the basis of internal markets and profitability, a massive bureaucracy is required to manage that internal market. That means that we end up with many managers working out who will get a contract to do which bit, rather than making the objective the totality of the hospital, the care system, the care service and whatever else it happens to be. We should be looking to more public ownership and intervention in the NHS, not less, and we should not be handing services over to private contractors.
It is not sensible to have a private contractor—say, Virgin Health—running a pharmacy within a hospital. That pharmacy should be part and parcel of the service of the hospital, where all are working for the same employer.

Marie Rimmer: I agree entirely with the sentiments expressed by my right hon. Friend. However, does he accept that, when we do not have the supply of workers to meet the needs at the time, we should bring in more nurses and doctors from abroad? We should do that while we assess the numbers that we need to train. Once we have trained more people, we can stop bringing in the staff from abroad. The same applies to contractors and the private sector now. What is not known widely is that many GP practices are private companies—they are not part of the national health service. Where that is not happening, we should be recruiting more GPs.

Jeremy Corbyn: I agree that the issue of recruitment is crucial, which means that the issue of training is  crucial. However, we have relied for a very long time, and we still do, on many medical professionals coming from other countries, making their homes here and making an incredible contribution to all of our lives. We should thank them, thank the Windrush generation and thank that generation of Irish nurses and others who came to this country to work in and run our NHS. My hon. Friend is right: when there is a shortage or a crisis, we need to reach out to somebody else—perhaps a private contractor—to help deal with it. I can see that happening in an emergency situation, but it has now become part and parcel of the NHS.
Most Members of this House grew up with the idea that the GP was the local person in a local practice. That GP might or might not have been in an NHS-owned building, but they were part of the NHS. We now have major American companies owning a large number of GP practices and providing that service. When I warned, during the 2019 election campaign, that the Government were in secret negotiations with the USA to allow American healthcare companies to enter our health market—as they deftly termed it—I was told that this was some kind of Russian plot that I was regurgitating. It was nothing of the kind. It was a dodgy deal done by this Government to bring in those private healthcare contractors who are making a great deal of money out of our NHS. What we need is public ownership of our NHS. I absolutely agree with the intervention of my hon. Friend the Member for St Helens South and Whiston (Ms Rimmer).
I think everybody would accept that the NHS performed brilliantly during covid. However, what the former Secretary of State did not say was that he managed to make a lot of monumentally ineffective contracts with Serco and others that made a huge amount of money out of track and trace—out of our NHS budget. Those places that used local public health services for track and trace had a much better outcome. We should recognise that the need to invest in local public health services for preventive measures such as track and trace, as well as for many other preventive health measures, is very important, because, as others I am sure will agree, that ends up reducing the overall costs.
A central part of my contribution today is about the care services in this country. Everybody knows that quite a large number of people in NHS beds cannot leave hospital because the care service is simply not sufficient and cannot accommodate them. That means that they are stuck in the worst possible situation. They are in a very expensive NHS hospital bed, where they do not want to be, and are in danger of picking up or passing on an infection while they are there. They want to be in a care facility, but there is not one available for them. That is a monumental waste of money and resources, and it is also very cruel on the individuals concerned. We have all met such patients in hospital.
There was a 15% reduction in care beds between 2012 and 2020. Now, 84% of our care services are owned and run by the private sector. There have been debates in this House for as long as I can remember about the inadequacy of social care, the need to invest more money in social care, and the need to provide for real social care.
Social care is a fear that stalks many families. It is the fear that an older relative—a parent, or whoever—will develop dementia or any other condition, and need social care as a result. The amount of money that they  would have to pay into the private care system terrifies people. To avoid that cost, who pays? Usually it is women in families who give up jobs, careers, and their life to care for somebody. It is not that they do not love their relative—they do love them—but their whole lives are turned around by the needs of care. We must grasp this nettle.
If in 1948, with all the post-war problems of investment, public austerity and so on, we were bold enough to develop a national health service, surely to goodness by 2021 we can be bold enough to develop a national care service, which takes away the fear for so many people of the enormous costs of healthcare—healthcare that at the moment is largely provided by the private sector on low wages and in sometimes not very adequate conditions. I think we need to revisit that. An interesting report produced by Unison on social care makes five recommendations, and I will quote the first:
“Remove the profit motive from the care sector. This would involve transitioning to either a national care service or a mix of not-for-profit provider types. If coupled with sufficient Government funding that meets the true cost of care provisions (something which is currently not in place), it would offer a number of benefits including greater financial accountability, value for public money, and likely greater attention to achieving quality care rather than generating a return for investors.”
People are making a great deal of money out of those with social care needs. I think we need to turn that around and ensure it is a public investment.
Our NHS was founded and put forward by very brave people, and it is something we should value and preserve. I think of the people who campaigned for many years on the national health service, but it has problems within it. It has the care problem that I have mentioned, and the inadequacy of mental health provision has been mentioned by a number of colleagues. Some years ago we mounted a huge campaign in my constituency to prevent Whittington Hospital from closing its A&E department. We were successful. The local papers, the community—everybody—got behind the campaign, and the A&E department is open and treats more than 90,000 patients a year. At the end of the campaign we held a celebration rally, and the main organiser of the campaign, Shirley Franklin, said, “Would you all have been here if it had been a mental health unit to be closed, or would you have stayed away?” I think we all know the answer to that. Mental health is seen as something separate and different that we simply do not want to talk about. We must invest in it fully.
This debate is about investing and extending, and thanking those who have gone before us. Some weeks ago I learned with great sadness that the late Alice Mahon died on Christmas day. I will be attending her funeral the week after next. She was a fantastic worker in the NHS, an auxiliary nurse, and I remember her like it was yesterday, standing up in this Chamber and challenging Ministers, be they Tory or Labour: “What are you doing to defend the principle of an NHS that is free at the point of need?” We can learn from the inspiration of wonderful people like the late, great Alice Mahon.

Marie Rimmer: I congratulate my hon. Friend the Member for  Jarrow (Kate Osborne) on securing this debate and on her strong and informative opening. I also commend my hon. Friend the Member for Bolton South East (Yasmin Qureshi) for her detailed explanation of dentistry. I am acutely aware of the issue but I could not go into all that detail, so I thank her sincerely for that.
Our NHS is not a faceless organisation; it is hundreds of thousands of dedicated workers who look after us. Their commitment is being exploited. Our NHS is the people who work in it, and they need to be, and should be, valued and treasured. This Government should be ashamed of the way the people in our NHS are being exploited. After years of Conservative-led Governments, our national health service is reaching breaking point. We have heard from many Members today about the problems with waiting lists, ambulance times, GP appointments and dental health. We need a national assessment of need, and some kind of national inquiry to get down to how we meet that need.
Things need to change, and change quickly, and I have two points that largely read into issues with GPs and hospitals, although our health service is much bigger. There must be a commitment to look at social care, which must be considered and addressed. Without that, we will never get hospitals right, because most of the beds that are taken up—I hate to say that—but could be freed up, are as a result of problems with social care. We must ensure that the funding we give for social care goes to the funded body.
The relationship between GP surgeries and patients needs to be addressed. We have heard about how many members of the public are illiterate, and they do not have confidence when they go to a surgery to argue their point. I have a case at the moment that is driving me around the bend. It involves a simple admin error—any of us could make an error, so I am not criticising anyone—and it has caused such anxiety to my constituent that I am receiving texts minute by minute. The bureaucracy involved between a GP surgery and a consultant to get something right is unreal. The relationships and training within GP surgeries need to be addressed.
There has been an absolute failure to adopt a long-term plan to recruit doctors, nurses and social care workers—social care needs to be treated as a profession, rather than simply going into a house to provide a bit of care. The crisis has been allowed to reach such a stage that a long-term plan is not enough. Urgent action is needed to tackle the lack of doctors and nurses. There is now no option other than to make it easier for the NHS to recruit doctors and nurses from abroad. There are 130,000 vacancies across the health and care sectors, and there is not enough time to train sufficient people to plug the gap. I respect the quality of the nurses and doctors we recruit from abroad, so I am not doing them down; we have to bring them in because we do not have what we need. We are having to use the private sector to fill the gap, but we should be thinking about our long-term needs. We should be recruiting and training people so that we do not have to keep recruiting from abroad.
The Government have failed to outline anything like a long-term plan for the health service. We need home-grown doctors, nurses and carers, and we need to think about what else we can do. We have lost so many surgeries. Why does the NHS not employ GPs? One of our surgeries in St Helens is run by the NHS. The Government have failed to offer more training places for doctors and nurses, and they have failed to prepare  our NHS for the future. The current crisis is putting a spotlight on the issue, which results from more than a decade of failure to adopt a long-term approach to staffing. Instead of adopting such an approach, each Health Secretary and Prime Minister has wanted to put their own short-term stamp on the NHS. We have had so many Prime Ministers and Health Secretaries in the past couple of years, and each has wanted to put their own stamp on the NHS. Our NHS is too important for that. It is too important not to have a long-term plan for recruitment and retention.
Labour will train 10,000 new nurses every year, and it will double medical school places. Training and recruiting staff is only half the story; the other important half is retention. NHS staff are leaving in droves, and morale is at an all-time low. We would not be able to handle another covid strain, as our NHS is not what it was three years ago because it has been drained and exploited. It is at its lowest ebb.
Keeping well-trained and experienced is staff is vital to delivering a good service to the public. We need to respect their skill and commitment. It costs a lot more to recruit and train new staff than it costs to keep existing staff. For more than a year, the Government clapped nurses on the doorstep, but they refused to give even the 2.5% increase that was already in the Budget, and now they will not sort out a third pay settlement.
If we want our NHS to care for us, we need to care for our NHS. The Government have lost the confidence of our NHS heroes, and that needs to change. Our NHS needs rescuing, and only Labour will do that. I think it is simple. The Government say they have a long-term plan, but Labour will deliver a long-term plan to save the NHS by plugging the staffing shortage with more training places, greater recruitment and better retention. That will give patients the service they deserve, a service for which we will always be thankful.

John Martin McDonnell: I want to get back to some statistics; I am sorry if I am going to bore the House, but I want to get back to some of the harsh reality. I know that subjective judgments have been made, but we cannot get away from some of the stats. I congratulate my hon. Friend the Member for Jarrow (Kate Osborne) on securing the debate and on an excellent speech, particularly in light of the fact that it was the Durham miners’ gala fundraising dinner last night.
I come back to the some of the harsh stats because I want to deal with why we need to address the funding crisis more effectively than we are at the moment. Some of these stats have been used already but I am still shocked by this: we have 7.1 million patients on waiting lists, which is almost double the level in 2010; and the average ambulance response time for patients in category 2 is now 48 minutes, which is half an hour more than it was a short while back, with the target of 18 minutes. I have met our local ambulance drivers and paramedics, and I know that category 2 is the heart attacks and strokes. I had a heart attack about 10 years ago and I do not want to be waiting for 45 minutes, as we are talking about the difference between life and death for some of us.
On A&E waiting times, the NHS target is 95% of people being seen within four hours, but the current  level is 40%. Most Members will have visited the A&E departments in their local hospitals. One of our local people described them as being like a warzone at times, given the number of injuries and scale of suffering. Members have mentioned the public satisfaction issue, but on the GP front—again, this comes just from working with local doctors—1 million people are waiting for more than a month. There are currently 4,500 fewer GPs than there were a decade ago. I understand what the Government and ex-Ministers are saying about the recruitment of more GPs, and I understand what my hon. Friends have said about a lot of that investment being from some time when the Conservative party was not in government.
I have been trying to look at the repairs backlog as well, because we have been promised a new hospital at Hillingdon. I am really pleased about that because I have been campaigning for one for years. We will be getting a new hospital, eventually, but that is largely because our existing one is in such a dangerous state; we are worried about the main structure collapsing at any stage and we have had to do temporary repairs. The repairs backlog has grown by 11%, to £10.2 billion-worth of backlog.
There is another figure that I have been worried about. Let me make it clear that I have been on the picket lines with nurses and in the campaigns. When talking to them on the picket lines, we get the true reality of what people are having to deal with, but I wanted to get behind the anecdotes and get to the stats. They show that one in five NHS trusts and health boards is providing food banks for staff, with a further third looking to provide them in the future. It must surely be shocking to everyone that NHS staff are having to rely on food banks —these are professionals.
If we look at the underlying causes of that, we see that this is about pay. I looked at the pay of the paramedics I was talking to and I found that it has gone down by £2,400 in real terms in the past year—that comes from some TUC analysis. There are now 3,000 ambulance staff vacancies in England. I went on to look at issues associated with nurses’ pay. The average nurse’s take-home pay is more than £5,000 less in real terms than it was in 2010—again, that comes from number crunching by the TUC, but all of this is verified elsewhere as well. There are nurse shortages, with 47,000 vacancies. The most worrying thing, which has been touched on to a certain extent by others, is that one in nine nurses left the profession in the past year, which is the highest level in a year in the recorded history of the NHS. That says something about morale. We have heard that the talks are scheduled for 1 and 3 March, and I am hoping that they will resolve the current dispute. However, it is difficult to see how it can be resolved unless all the unions are engaged in those discussions.
A few years ago, there was a junior doctors pay dispute. My right hon. Friend the Member for Islington North (Jeremy Corbyn) and I were on the picket lines and at the demonstrations for that as well. So I was looking at what has happened with the junior doctors, who are represented by the BMA. As someone has said, 98% have voted for strike action, on a turnout of 77%. I do not think we have seen those levels of turnout in recent history in these ballots for industrial action. Again, I have been trying to get behind the reason for that. BMA analysis shows that the pay of junior doctors has been cut by more than a quarter since 2008. It looks  as though we are going to have a walkout for 72 hours in March, which, obviously, will have an impact on the service. When I talk to junior doctors, they tell me that they do not know what else they can do. They are beginning to struggle to survive on the wages they are getting. In constituencies such as mine, a west London, working-class, multicultural community, most of them will never be able to get onto the housing ladder to buy a property; in fact, because of the level of rents, many will struggle even to fund the rents there. Trying to come at this question as objectively as possible, it must come back to underfunding. There is no other reason that I can see.

Rob Roberts: I appreciate the right hon. Gentleman giving way and the tone in which he approaches the debate. He talks about funding, but Labour left office in 2010 and there was no argument about the fact that funding was not sufficient at the time of the last Labour Government. The King’s Fund says that statistics show that funding has increased or at least kept pace in real terms since then, so how is it not sufficient now?

John Martin McDonnell: That is an extremely valid point that must be addressed. When some of us were doing health economics in the 1980s and onwards, we were always told that the level of funding required just to maintain a standstill operation for the growing ageing population was at least 4%. What happened under Labour was a 6% annual rate of funding.
I will be honest with the hon. Gentleman: when I was on the Government Benches and Labour was in government, I was asking for more. Gordon Brown, to give him his due, had a sense of humour; I always used to produce an alternative Budget, so he described me as the shadow Chancellor even when I was not. I did that on the basis that I thought 4% was not enough and, while 6% was right, we needed to go further, because it was about not just the ageing population but the increased levels of morbidity we were experiencing. In addition, as the hon. Gentleman mentions, new treatments come on board and are more expensive.
Even though I was looking for increased investment, beyond what Labour was doing then, Labour was not just keeping pace with the 4%, but was going beyond it at 6%. To be frank, although the hon. Gentleman swore in the Chamber earlier, he should have heard some of the language I used in 2010, because I was quite angry as well. Those of us who were there will remember that in 2010, investment dropped to 1%. We were saying to George Osborne, who was the Chancellor at the time, “You are going to reap the whirlwind here for dropping the level down to 1%, because it means an erosion of the services that are provided.”
In addition, that investment did not recognise our ageing population or the other emerging issues with morbidity. I understand that the covid inquiry will include analysis of the resilience of the health service to cope with the covid pandemic. I believe that a number of those representatives are seeking to have George Osborne appear before that inquiry, because he bears responsibility for that under-investment.
Other hon. Friends have mentioned mental health, and I agree that it has been the Cinderella service. When  I looked at mental health funding, I found that it has increased at a faster rate than overall NHS funding—at times nearly 3% as against 1%. However, that follows years of small increases or real-terms funding cuts, and the number of NHS mental health beds is down by 25% since 2010.
Curiously enough, I was on a bus in my constituency yesterday with a former mental health nurse, who described to me the implications of that and the consequences for the individuals concerned. Community mental health nurse numbers were also impacted upon. Some of us will have dealt with the results of that in our constituencies; in my constituency, I have to say, it has meant dealing with suicides as well.

Jeremy Corbyn: Is my right hon. Friend aware that the impact of an inadequacy in healthcare provision falls on A&E departments, which take in people who have mental health crises but are ill-equipped to cope with them; on neighbourhoods that cannot cope with people going through crises; or on the police, who have to intervene simply to look after someone for whom there ought to be mental health provision. We fail to invest in mental health provision at our peril.

John Martin McDonnell: Anyone who has talked with them will have heard local police officers say that they have become social workers, mental health workers and so on. In many instances, they are doing the best job that they can, but they need expert support, including from health workers in the community.
I looked at the figures, and there are now 1.6 million people on the waiting list for specialist mental health services. One of my concerns, which was raised in a debate some months ago, is what is happening with CAMHS —child and adolescent mental health services. Delays in treatment have increased massively since 2019, and waiting lists are getting longer. I have looked at the stats: 77% of CCGs froze or cut their CAMHS budgets between 2013-14 and 2014-15, which was the crunch year; 55% of the local authorities in England that supplied data froze or increased their budgets below inflation; and 60% of local authorities in England have cut or frozen their CAMHS budgets since 2010-11. Again, that is staggering.
To come back to mental health nurses, in 2010, we had 40,297 of them; we are now down to just 38,987. That does not seem a significant drop, but it is still a drop. As a number of Members on both sides of the House have mentioned recently, we are going through a mental health crisis—one that affects young people and young men in particular, as my right hon. Friend the Member for Islington North has pointed out.
Let me come to the stats on social care. Age UK estimates that more than 1.5 million people aged 65 and over have some form of unmet or under-met need—[Interruption.] Excuse me—[Interruption.] Thanks a lot; I could do with something stronger.

Alex Cunningham: That can be arranged later.

John Martin McDonnell: That’s right.
The social care figures are startling. Some 1.5 million people aged 65 and over have some form of unmet care need. There are 165,000 vacancies in the social care sector across England and Wales—a 52% increase in the last year. The Health Foundation estimates that an extra £6.1 billion to £14.4 billion will be required by  2030-31 to meet the demand. As others have said, that has meant delayed discharges from the NHS, and—as I mentioned on Tuesday—it places a huge burden on unpaid carers, who are living on the pittance of the £70-a-week carer’s allowance.
The Institute for Government published a report today in which it basically argues for social care overhaul. It describes how social care has been overwhelmed in recent years and states that 50,000 fewer posts are filled than a year ago—the highest vacancy rate ever in social care. Then, there are the stats on what has happened as a result of under-funding—and I am afraid that it is because of under-funding; we cannot get away from that fact. I would be saying the same thing on these statistics no matter which party was in power. We need to go further in the coming month’s Budget.

Rob Roberts: The right hon. Gentleman is being very generous with his time. He will know, having been shadow Chancellor, that in the devolved Administrations, there is £1.20 in Wales for every £1 in England, and slightly more in Scotland. The results—I could say they are worse, but I will not—are measurably the same. Is it a problem only of funding, or is it one of structure?

John Martin McDonnell: I am sure that the hon. Gentleman has made that point before. I looked at the Nuffield Foundation report on Wales a couple of years back. I do not think that Wales has had a good deal out of the Barnett formula over the years, and although the Government have addressed some of that over the past year, they have not done enough. The Nuffield Foundation said that Wales has not only an ageing population, but higher levels of morbidity, so the funding does not match the need. A whole debate needs to take place about moving forward. When I was shadow Chancellor, I talked about a review of the Barnett formula. That frightened a number of people, but it is needed. In fact, I think there is a need for a Barnett formula for the north of England as well. [Hon. Members: “ Hear, hear!”] I thought that might raise a response.
There is a long-term funding crisis that we have to address. I look forward to next month’s Budget for some resolution of this matter. Where can the money come from? I know that a lot of people say we should never make unfunded commitments. To be honest, I was the first shadow Chancellor who produced a Budget and a manifesto that was fully funded and costed, in the “Grey Book”, so I want to look at some ideas and just throw them out there.
On Tuesday, we heard that, as a result of the higher level of tax receipts received than the Office for Budget Responsibility predicted, the Chancellor now has £30 billion of headroom that he did not have previously. Some of that £30 billion needs to be invested in the NHS, and particularly social care. I would also like to see some of that money invested in relieving poverty, which is one of the major causes of ill health in this society.
We need to do something on capital gains tax. If we taxed capital gains at the same rate as earned income and charged national insurance on it, we would get £25 billion extra. Let me throw in a few others. If we lifted the higher national insurance rate, so that instead of 3.25% above £50,000, it was paid at what everyone else below that level pays—13%—that could raise us  £15 billion. I cannot for the life of me see why dividends are not taxed at the same level as earned income. If we did that, we could raise £8 billion. Those on the Labour Front Bench have put forward the idea of scrapping non-dom status. Again, I claim copyright on that one. That would raise between £1 billion and £3 billion.
The Government have implemented a windfall tax on the excess profits of energy companies, and they should extend that, as those on the Labour Front Bench have advocated. Some Members may have read the recent reports on bank profits and the return of extremely excessive bank bonuses. There is an argument for a windfall tax on bank profits during this extremely difficult period. This is a time when we should all bear the burden of the challenges that we face. Taxing the bankers’ bonuses needs to come back on the agenda, and I deeply regret that the Government removed the cap on bankers’ bonuses, which we supported.
With regard to the City, I have been an advocate of the financial transaction tax for a number of years. All it does is close some of the loopholes in terms of stamp duty. If we look at the work on this recently by Advani and others, we see the potential. With limited changes, we could raise £8 billion to £10 billion.
It is time to start looking at how we tax wealth in this country more effectively. If we look at the proposals that have been produced by various think-tanks over the last year or so, a 1% tax on people who have assets over £10 million could raise an additional £10 billion. This is not revolutionary stuff. It is straightforward and pragmatic, making sure that we have a fair taxation system.
Those on the Labour Front Bench have argued strongly that we have to go for growth, as have the Government. I fully agree, but that needs a rapid programme of investment in the public sector, with matching private sector investment. If we can increase growth by just 1%, we usually match Governments receipts at the same time by 1%, which would mean about £7.7 billion, and for 2% it would mean £15.4 billion. In addition to the short-term taxation measures, redressing the imbalances in our taxation system at the moment, that would enable us to achieve the growth that will give us a stable form of income to meet the needs of our NHS and social care system.
We cannot continue with an NHS and a social care service that is paid for on the backs of people we are exploiting in long hours, undermining their morale by not paying them properly, and at the same time making them face challenges that are both heartrending and certainly not what many of them signed up for. The NHS workers I have met just want to provide a decent service in a caring environment that is fully funded, where their profession is respected by being properly paid. I hope that we can achieve that sooner, rather than later.

Alex Cunningham: We can all be very proud of our NHS and the people who care for millions of patients every year, whether that be in GP or dental surgeries, in hospitals, or in the community. However, a lack of appropriate funding and workforce planning across the piece has made those people’s challenges greater than they need to be. They are let down almost every day.
Today, I want to address one specific issue affecting the running of services on Teesside, but I would first like to welcome the decision to fund a new diagnostic centre in Stockton town centre, and to comment on some trusts in the north. That new diagnostic centre is a direct result of a great partnership between Stockton-on-Tees Borough Council and the local health trust, and will go some way towards addressing the tremendous health inequalities in my constituency and elsewhere on Teesside. What we really need, though, is to have our ageing North Tees hospital replaced, and I remain hopeful that one day, we will get it. That replacement hospital was planned 13 years ago, but was shelved by the Tory-Lib Dem Government in 2010.
Trusts in our region have faced challenges of late, with inspection outcomes that have been far from great. They go across the piece, from the mental health trust to hospital trusts and the north-east ambulance trust. For me, that illustrates a systematic failure of Government: everywhere is under pressure. As I said earlier, it is always interesting to listen to former Government Health Secretaries and people on the Government Benches—I note that only a Whip and the Minister now remain on those Benches—talking about the problems in the national health service. Sometimes, they even offer a few solutions, but what have they been doing since 2010? I will tell you, Mr Deputy Speaker: they have been growing the waiting lists and alienating the staff.
Despite a couple of ideas for improvements from Conservative Members, it is abundantly clear that the Conservatives are out of ideas when it comes to fixing our broken NHS. That task is too much for this Administration, who have overseen a decline in their 13 years. A Labour Government will undertake the biggest expansion of medical training in the history of the NHS to give it the staff it needs. The last Labour Government delivered the investment needed to bring waiting times down to their lowest ever levels, and also restored staff pay to fair levels. We were able to do that because we grew the economy and created the revenue to fund our public services, something that seems to be beyond the current Government.
I was proud to serve as a non-executive director of the North Tees and Hartlepool Hospitals NHS Foundation Trust before I was elected to Parliament 13 years ago. I was also proud that that trust was recognised, not just for sound finances and delivery for patients, but for innovation and a can-do, will-do attitude. Much of the credit for that performance being maintained goes to the non-executive directors who gave a large part of their lives to the trust and provided a robust challenge to the executive. That ensured that the trust’s performance, finances, and proposals for new projects were examined in detail—not simply signed off, but forensically examined to ensure they were all delivering for patients. We all owe a tremendous debt of gratitude to all independent non-executive chairs and directors for the work they do across our country, often in the most difficult of circumstances.
Sadly, we have recently seen our trust go through a very difficult patch, including the resignation of several non-executive directors, a few of whom I put on record as my friends. That happened after the NHS England regional board launched an investigation that basically  questioned the integrity and performance of the trust’s board, and in particular its non-executives—a trust that was rated “good”. The contents of the ensuing report sadly remain shrouded in secrecy, although what can only be described as a well-edited summary was published last year.
In the summary, there appears to be a failure to acknowledge the actions and behaviour of the chair and the regional office in pushing through a proposal for a joint chief executive officer to cover the North and South Tees trusts. Instead, it focuses almost entirely on the former non-executive directors, all of whom served the trust diligently for a number of years and oversaw outcomes that we can all be proud of.
I wish the Minister was listening, because the full report is being kept under wraps by NHS North East and Yorkshire executives, despite the regional director, Richard Barker, sitting in my office and assuring me that it would be made public. Despite a series of emails to NHS England, that is yet to happen. My application under the Freedom of Information Act 2000 on 17 November, although acknowledged, has yet to be responded to. It strikes me that the regional bosses do not want it to be published. Bearing in mind the gravity of what happened, I wonder whether it has even been shared with the NHS England national board, as it ought to have been.
What is going on in the management of the NHS northern board, particularly in relation to the North Tees and Hartlepool Hospitals NHS Foundation Trust? It goes back two years to the appointment of a joint chair with the South Tees Hospitals NHS Foundation Trust—those two trusts have worked together closely for longer than I care to remember. Within weeks of the appointment of Professor Derek Bell, he proposed to appoint one chief executive for both trusts. From the controversy that followed, it appears that it was presented more as a done deal, but I still wonder where it had been determined.
It was not just that, but what was seen as a disproportionate emphasis on structural change across the two trusts with the appointment of that joint chief executive. That approach is contrary to the evidence relating to success in a health and care system, whereby strong system leadership and collaboration are essential to represent local communities, incorporating local stakeholders and populations. Indeed, the benefits realisation to populations and patients of integration and collaboration occurs in trusted relationships and focused system leadership.
The problems started at that point, with the non-executive directors insisting on due process and consultation with the trusts’ wide range of partners. They were also concerned, as was I, that it was the start of a merger process for the two trusts—one high performing, North Tees, and the other struggling and under considerable scrutiny from the Care Quality Commission, South Tees. No one would fail to sympathise with those non-executive directors’ concerns. They, in particular, are required to be independent and to ensure that they put patients’ interests first. That is exactly what the team at North Tees did—they made a robust challenge to the proposed changes, which was clearly not appreciated by the chair and NHS bosses, who mounted an investigation.
I could go on at great length about the to-ing and fro-ing, but suffice it to say that most of the non-executives resigned, which I suspect is just what the powers that be  wanted to happen. In other words, they wanted the removal of people who were not sticking to the line or doing what the officials wanted, but were maintaining their independence and putting patients first.
That sorry saga raises issues about the running of foundation trusts, which are supposed to be standalone organisations that make decisions for their local community. They are not supposed to be carrying out the orders of someone in a regional office 40 miles up the road. Let me be clear: no one wants to resist change and no one would stand in the way of an eventual merger, but it has to be at the right time and always in the best interest of patients. People north of the River Tees do not want their hospitals to be mere satellites of their larger neighbour eight miles down the road; they want services in their home towns of Stockton and Hartlepool.
To go back to the mystery report, I appeal to the Minister to encourage the NHS board in the north to carry out its promise and publish the report. It calls into question the integrity of people of long-standing service, yet not even they have been allowed to see it. I suspect that it remains under wraps because it is critical of not just the non-executive directors—in fact, I know that to be the case. Mr Barker told me in my Stockton office that it would also be critical of the chair’s role in the scandal, which, as I said, was omitted from the summary report. That is totally wrong. He, too, needs to be held accountable, and I have in the past called for his resignation. Perhaps the report even features the regional officials, who I certainly believe have some questions to answer about the appalling way they have handled this matter, including in refusing to publish that report, as promised.
As I draw to a conclusion, I would like to share with the House how the board is now made up. Previously, it was of people from the North Tees and Hartlepool trust area, and I always thought that boards were supposed to be representative of and from their communities, yet none of the new non-executive directors is local, and one of them comes from Stockport. I do not know how many miles it is to Stockport, but it is at least 130 miles from where the trust is based, which is not good. When the current vice-chair, Steve Hall, steps down in a few weeks’ time, there will not be a single person on the board who lives in the trust area. In the words of a certain former Prime Minister, “That is a disgrace!”
I would therefore be grateful if the Minister, instead of reading his papers, actually listened to me and got involved. He should find out why this sorry mess was allowed to be created, and ensure that that report is published. To do otherwise would be not only unfair, but a dereliction of duty.

Margaret Greenwood: I congratulate my hon. Friend the Member for Jarrow (Kate Osborne) on securing this important debate.
The NHS is in crisis. Vacancies last September were at over 133,000, and waiting lists for routine treatments had reached over 7 million. The Government will say that this is because of covid, but that is not the case. Vacancies and waiting lists were already unacceptably high before covid; covid has made what was a terrible situation even worse. These problems, together with the fact that nurses and other dedicated NHS staff are severely overstretched without enough colleagues to  work alongside them, are the result of consistent failures by Conservative Governments to plan and provide for safe staffing levels. None of this has happened by accident. It has happened by design, because the Conservatives are intent on undermining the NHS as a comprehensive and universal public service. That has been the case for decades, and it is their drive to put business rather than patients at the heart of the NHS that has led us to where we are now.
The book “NHS for Sale” by Jacky Davis, John Lister and David Wrigley sets out some of the background on what key figures in the Conservative party have thought about the NHS over the years. The book highlights how, in 1998, Oliver Letwin—at the time a future Government Minister—wrote a book called “Privatising the World: A Study of International Privatisation in Theory and Practice”, which talked of increased joint ventures between the NHS and the private sector, ultimately aiming to create a
“national health insurance system separate from the tax system.”
“NHS for Sale” also highlights how, in 2008, the current Chancellor of the Exchequer co-authored a book called “Direct Democracy: An Agenda for a New Model Party”, in which he said:
“Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of healthcare in Britain”.
A few years later, in 2011, the then Prime Minister, David Cameron, made a speech in which he said:
“From the Health Secretary, I don’t just want to know about waiting times. I want to know how we drive the NHS to be a fantastic business for Britain.”
It should therefore come as no surprise that Conservative Governments have long been squeezing the supply of NHS provision and driving demand for private healthcare. There is perhaps no better evidence of this than the Health and Social Care Act 2012, which in effect allowed NHS foundation trusts to earn 49% of their income from treating private patients. Before the Bill was amended in the other place during its passage through Parliament, it set no limit on private income, demonstrating that the Conservative and Liberal Democrat coalition Government had initially planned to enable NHS foundation trusts to earn all their income from treating private patients, if they so chose. That is astonishing.
Had the Conservatives and Liberal Democrats been able to go through with their initial plan, the impact on NHS patients could have been catastrophic. In 2011, the majority of NHS foundation trusts had private income caps of between 0.1% and 2%, so for Government legislation to allow 49% really does show a determination and a desire to put business rather than patients at the heart of things in the national health service. It also demonstrates the sheer ruthlessness of the Conservative party’s ambition when it comes to privatising the NHS and undermining it as a comprehensive and universal service.
There have been recent reports that some NHS trusts are promoting expensive private healthcare at their hospitals, offering patients the chance to jump NHS waiting lists. That is a matter of extreme concern and will lead to a two-tier system where people who have the means to pay can get treated more quickly, while NHS patients face longer waits, often in pain and discomfort. That fundamentally undermines the NHS as a compressive   and universal service, and is not in the spirit in which the NHS was created. I have called on the Government to put an end to NHS facilities being used to provide services to private patients, and I do so again. I thank colleagues who signed my early-day motion 805 on that.
In recent months, members of the Royal College of Nursing have taken strike action for the very first time in their 106-year history, as they fight for fair pay and improved patient safety. I have been proud to stand with nurses on picket lines. They have told me how stressed and burnt out they are because of staffing shortages. I know that they do not take strike action lightly. Their dedication to their patients is immense. Some have spoken about the stress they feel at shift handover times when there are not enough staff to take over, and how they end up working additional hours without pay to ensure that patients receive care.
That it is only this week, after months of dispute, that the Government agreed to get round the table with the RCN speaks volumes about how little they value the NHS workforce. Earlier this week, Professor Philip Banfield, chair of the British Medical Association council, said that the Prime Minister and Health Secretary were
“standing on the precipice of an historic mistake”
by failing to stop national NHS strikes. I hope that the Government are listening, because this is in their hands. Professor Jeremy Farrar, the director of Wellcome and soon-to-be chief scientist at the World Health Organisation, warned that healthcare workers are “absolutely shattered”, and that
“morale and resilience is very thin.”
The Government need to put things right and come forward with a solution to the disputes that are fair for hard-working nurses, ambulance staff and other dedicated NHS workers. The Conservatives have left the NHS underfunded and under-resourced. They have pushed staff to the brink and left them thinking that their only option to get their message across is to go on strike.
I believe that the NHS is one of this country’s greatest achievements. We know that if we become ill or have an accident, it is therefore us, free at the point of need. We must do all we can to oppose privatisation and fight for the NHS as a comprehensive, universal, publicly owned and publicly run service, free for each and every one of us whenever we need it.

Rachael Maskell: I thank my hon. Friend the Member for Jarrow (Kate Osborne) for securing this really good, much-needed and timely debate. It is a pleasure to follow my hon. Friend the Member for Wirral West (Margaret Greenwood), who set out the ideology that sits behind the Government party.
Driven by the injustices of inequality, 75 years ago we saw the advent of the NHS under Nye Bevan. Health has moved forward ever since, until just recently when we have seen a drop in life expectancy. It is the injustices exposed today that have motivated many of us to speak in this debate. Just yesterday, as a member of the Health and Social Care Committee, I had the privilege of visiting Great Ormond Street Hospital. I have been steeped in health all my working life—for the record,  I declare that I am a member of Unite and the GMB. I was head of health at Unite and prior to that I worked for 20 years as a senior clinician in the NHS.
I recognised the most caring of staff and the most visionary of leaders at Great Ormond Street. They are carrying out medical advances that we could only have dreamed about just a few years ago: cures for rare cancers that no child could previously have survived; state-of-the-art technology keeping the most delicate of hearts and lungs working; and research and science breaking new frontiers. However, like in my own patch in York, when they intersected with social care, the whole system ground to a halt. They cannot get the staff.
Let us not be shocked: social care cannot get the staff because the Government have not provided the means by which to pay them. Many are doing highly skilled, professional roles, but are paid a pittance. If they were employed on “Agenda for Change” pay scales, which are job-evaluated, we would not be carrying the 165,000 vacancies we see today. We would not have the delayed discharges and flows in hospital would return to some semblance of normality. Patients would get into emergency departments, freeing up ambulances to reach the sick in time. Stress levels of staff would fall and absenteeism would drop. But the wealthiest sitting in Cabinet do not understand that that is fiscal responsibility.
Let me set out the challenge. In York, the local authority does not have social care capacity because staff are too low paid. Wages are very low and the cost of living is very high. The local authority is having to buy beds in residential homes, at around £1,400 per patient, per week. That is not out of the ordinary. To provide a timely social care package would have cost just £500 for the maximum package. The Government are paying £900 more per patient, per week. Imagine if that £900 went on social care staff pay—just hold that thought.
No patient who goes into hospital independent, who then has a delayed discharge and ends up placed in residential accommodation because there is no care package available for them to go home, goes home from residential care—that is the case even though they were independent before they went in. Instead, they become deconditioned and dependent, with both the taxpayer and the patient paying a heavy price. The cost of that is £1,400 and rising throughout the patient’s life—not £500 and falling as the patient becomes more independent. If that money were spent on recruiting, training and paying care staff the wages they deserve, we would see no delayed discharges. Patients would be at home and independent, and thousands of pounds from the Health and Social Care and DWP budgets would be saved.
To make sense of the crisis, this is not just about the amount of money; it is about where the money is placed and how it flows. We could say the same about paying exorbitant amounts to the social care providers that are making billions in profit between them, as opposed to having a state-run social care service—what I would call a national care service—that is publicly accountable and controlled. The Government need to look at the waste in the system, and not just talk about the amount of money they are putting in. If we addressed those issues, we would make savings, pay the staff what they deserve and have a system that works for everyone.
In 2004, Labour created “Agenda for Change”, which put NHS staff on decent terms and conditions and pay. All the Minister has to do is to put people doing exactly  the same tasks in social care as they do in the NHS on that job-evaluated scheme. That would put the staff on those wages and terms, and give them the career opportunities that were created under the Labour Government through the knowledge and skills framework. It would save money and ensure that people get the pay they deserve. That is not a massive ask; it is common sense.
That would also mean that we would start getting integration. As I said at the Health and Social Care Committee, the problem is that we still do not have a system that can integrate. Integrated care systems are collaborating at best, not integrating. They have separate funding, separate staffing and separate policies—we kid ourselves if we think that is integration. However, we need integration because we need to bring the whole system together.
We also need to look at the workforce across the board. The Chancellor, when he was Chair of the Health and Social Care Committee, set out his determination to stop workforce depletion after 12 years of this Government. He recognised how it was impeding the NHS. But now there is no workforce plan to behold. As Labour did in 1997, we will recruit the workforce the NHS needs. We understand that staff need a pay rise. When the NHS cannot retain staff, it pays more to agencies. Last year, the NHS paid £3 billion for agency staff. If that money had gone into the pockets of NHS staff, the NHS would have retained them. Staff are now leaving at the highest rate ever: 42,411 staff left in the second quarter of last year. We understand that we cannot keep taking out of the NHS; when the staff are not there, we cannot train the next generation. Of course, we then pay more and more for agency staff.
Turning to health visitors, I commend the Government for putting forward the health visitor implementation plan. In 2010, there were 8,092 health visitors, which was 4,200 short of the number required for safe working levels. The Government made it their objective to recruit those staff—it was a No. 10 priority—and did so over five years, scraping by in achieving it. However, the Government did not invest in those individuals, so come August 2022 there were just 7,013 health visitors, 1,000 fewer than in 2010. That means that we just do not have the health visitors—key public health professionals —to keep patients safe. Health visitors are working under considerable stress and strain, as well as not making the interventions that are desperately needed. This can and must be addressed. While we have promised to do so, the Government have been silent on health visitors.
We have heard much about dentistry challenges in this debate. The data shows that 26 million appointments have been lost since 2018-19. In York, 126,130 appointments—62% of them—have been lost. Many people are seeing their dentists every other year, and virtually none of my constituents has seen an NHS dentist. I know that to be true, because nobody is able to see an NHS dentist unless they are a long-term patient. People are often waiting five or six years to see a dentist. The oral health of my constituents has been failed because the Government have not put the right measures in place. We are losing the workforce and dentistry is being privatised before our eyes. Intervention is needed now, and it will make a difference.
Of course, we are talking about not just dentists and health visitors but the NHS as a whole, and we know that the story is the same in maternity services, emergency  departments, urology departments and all specialties. Nurses, physios, doctors, pharmacists and so many others should not be in the position of having to beg for a pay rise. They should be valued—and, of course, if we value something, we pay for it. Decent pay retains and attracts staff, which results in productivity soaring. When Labour came to power, the NHS had a pay rise after the Tories had decimated it. I worked in the NHS, so I know that people were on their knees, working double shifts and often working into the night when they should have gone home hours earlier. The same is true today, but if we invest in staff, productivity will rise and the outcomes will be so much better. People are burned out and breaking because they are unable to be the professionals that they trained to be. They cannot practice what is written into their DNA because the pressures are so great. But I say to them, hold on, a Labour Government are on their way.
This talk of using the private sector must stop. If we are serious about rebuilding capacity in the NHS, clearing backlogs and addressing the challenges—the Government, of course, are being very sluggish because they are not fixing the challenges as they come—we need to move staff back into the NHS as well as keep staff in it. The NHS has more than 133,000 vacancies right now. We need to get people back into the system and to pay them and respect them. If they are being paid more in the private sector, of course they are going to stay there, but we need to stop reinforcing the system of privatisation by moving work to that sector. We need to get those staff back into the NHS, working in a service of which they can be proud. That would also help improve patient flows across the NHS.
I visited the amazing NHS staff in the emergency department in York just a few weeks ago. They want to do the job that they were trained to do, but they are having to manage a decline in staff as people go to agencies for better pay. They have to work alongside agency staff who are paid more than them, as are the CIPHER staff who come in and sit with patients—a move enforced by the NHS. That hardly boosts morale. And then we have Vocare—the least said about it, the better, as it sucks money out and fails to provide the necessary service. We cannot have patchwork privatisation. It does not work and it increases risks. We need to see the end of this fragmentation. Instead of paying more for private, we should pay the NHS staff and get them back on to the wards, holding their heads up high again, confident that they are working for a service in which they are valued.
One more thing on where the funding goes: if discharge funding goes to the acute sector, it can build more institutions, which is what the Government have decided to do. What it cannot do is push people out of the system, but if we gave that funding to social care, it could bring people out of the system. Therefore, joining up these new transitional units with hospitals has been a waste of funding. We should have invested in social care, so that those people can get home, get the care they need there, and get mobile and moving again, which would improve their quality of life. The Government have got it wrong again because they do not understand the system. They just listen to who is shouting loudest and throw out money, as opposed to hearing what can make a real difference.
I want to talk briefly about primary care, because Nimbuscare in York have achieved so much. It set up a paediatric assessment unit to take the pressure off  admissions to the emergency department. The system is run by GPs and has saved 1,300 children from going into acute A&E. In fact, only 3% of referrals from the unit had to go on to A&E, and only one child was admitted. This is simply about understanding patient flows, who has the expertise, who can make the diagnosis, and who can provide the solutions and treatments, and about putting money in the smart place: in the NHS.
There is so much more that Nimbuscare could do if only it had the money—taking all that expenditure out of the NHS and ensuring provision in the community and primary care, as opposed to secondary care. It works, it is more effective and it is better for patients—and of course there are other specialties, such as elderly care or women’s health, and respiratory clinics and others who need support. We can then start to see prevention and interventions being made, such as health checks, to ensure that people get the support they need. We can introduce social prescribing, to ensure that people have healthier and happier lives. There is so much that can be done, if only the Government had the kind of vision that Nye Bevan had when he set up the NHS. It is not about managing the system; it is about feeling the injustice and the inequality, and putting in the solutions that are needed.
In closing, I want to touch on health inequalities. The health disparities White Paper has been scrapped, the 10-year cancer plan has been scrapped, the 10-year mental health strategy has been scrapped, and the Khan tobacco control plan has been scrapped. There is no plan for management around alcohol, and we have not seen a strategy on gambling. Public health has become the poor relative of the NHS, when prevention should be driving the NHS. Of course, the NHS public health workforce have been decimated under this Government, so how are we meant to shift the dial for the future? Michael Marmot has set out exactly what needs to be done, and he has looked not only at healthcare but at the broader issues of poverty and what really drives the inequality across our society, as has been said.
We need to put the investments in the right place, which is what this Government are failing at. It is what the next Government will do when Labour comes to power. If only the Health Secretary, and indeed the Minister, could look at the evidence, understand the system, and put their feet in the shoes of people who work in the NHS, we would make such a difference. If nothing else, let us in York pilot some of these ideas. We are really keen to do so, because we know it will make a difference.

Liz Kendall: I congratulate my hon. Friend the Member for Jarrow (Kate Osborne) on securing this important debate. It really is a privilege to speak after so many powerful and passionate contributions.
I want to start by telling the House about my constituent Mo Peberdy and her father, who is 83 years old. He has stage 5 kidney failure, diabetes—which has already led to a serious foot infection and the loss of one toe—and early-onset dementia. He is on a raft of medications and he has carers coming in four times a day.
On the weekend of 10 and 11 December, Mo’s father started to go downhill. By the 15th, he was in crisis. He had hugely swollen testicles and terrible sores all over  his groin and backside. He could not eat or drink, let alone sit down, and he had severe diarrhoea, which was green and contained blood.
Mo immediately called the GP. She was told that no one was available and that she needed to ring out of hours. She did. When they called back several hours later, she was told to call 111. Mo called 111. Again, she waited several hours for them to ring back. When someone eventually did, at 6 pm, they said her call had been transferred to 999, so Mo and her father were told they had to wait for an ambulance—and wait, and wait, and wait. It was not until 8 am the next day—14 hours later—that a paramedic finally arrived.
All that evening, night and morning, Mo tells me,
“my dad was screaming in agony, wanting, begging to die… to listen to him in such pain, I will never forget it in all my life… My dad is one case amongst many… Our NHS is broken… We have to change from the top.”
She is right.
Time and again in this debate, we have heard about the crisis in our health and care system after 13 long years of this Conservative Government. More than 7 million people are now waiting for hospital treatment, after Labour ended waiting in the NHS. In the last month alone, 42,700 people waited more than 12 hours in A&E, and people who needed category 2 ambulance responses for suspected heart attacks and strokes waited one hour and 33 minutes on average. The target is 18 minutes.
The Royal College of Emergency Medicine estimates that up to 500 more people are dying every week due to delays in emergency care. I hope that the Minister will say what the Government are doing to investigate that and put it right, because it is a national scandal. The target that patients with suspected cancer should not have to wait longer than two months from GP referral to treatment has not been met since 2015.
As many colleagues have said, the situation in social care is even worse, with 1.5 million older people who need help with the very basics of daily living—getting up, washed, dressed and fed—not getting any help at all. Even among those who are in the system, half a million are waiting to have their care needs assessed or reviewed, or for treatment to start. Some 2.5 million unpaid family carers have been forced to give up work because they cannot get the help they need to look after their loved ones. With staff shortages in so many parts of the economy, where on earth is the sense in that? That basic issue—staff shortages—is at the heart of so many of these problems. There are 133,000 vacancies in the NHS and 165,000 in social care; the combined total is the same as the population of Newcastle. What a damning indictment of this Government.
Nobody denies that the covid pandemic and its aftermath have posed huge challenges to the NHS and social care, and I pay tribute to the frontline workers who gave us their all and got us through those dark days, but the reality is that NHS waiting times were at record levels, staff shortages were soaring and social care was stretched to breaking point long before the pandemic struck—something the Government refuse to acknowledge.
This dire situation makes the Government’s refusal to deal properly with the current industrial action in the NHS even more unforgivable.
I am pleased that Ministers are finally talking to the Royal College of Nursing about pay, but why did they not do that before Christmas, when the RCN first told  the Government that it would call off the strikes if Ministers just got round the table for meaningful talks on pay? Why are they not also meeting the other unions and the junior doctors? Since the RCN first made its offer, 140,000 operations or hospital appointments have been cancelled as a result of the strikes. Those cancellations could have been prevented if Ministers had done their job and got round the table.
My constituents, and people throughout the country, deserve a Government who get on with the job, and they need a proper plan to get our NHS and care system back on track. That is why I am proud that my right hon. Friend the Leader of the Opposition has announced today that building an NHS fit for the future is one of Labour’s five key missions for government.

Rob Roberts: If Labour Members have this plan, have they communicated it to the Welsh Health Minister? Why is this not happening in Wales? With the greatest respect, and I really do not want to score these political points—

Alex Cunningham: Don’t score them, then.

Rob Roberts: It is not a political matter! These issues affect the entire United Kingdom. Does the hon. Lady agree that that is the case? Does she agree that these matters are just the same in Wales as they are here, and that we need much wider reform?

Liz Kendall: May I gently say to the hon. Gentleman that I know what is best for his constituents and the people of Wales, which is a Labour Government in Westminster as well as a Labour Government in Wales delivering the changes that we are seeing? If he looks at Labour’s record when we were in government in Westminster, he will see the improvements that were made. May I also gently suggest that he focus on the lack of a workforce plan and the lack of a proper social care plan from his own Government, rather than trying to make these petty points?
Our plan will reform health and care services to speed up treatment by harnessing life sciences and technology to reduce preventable illness, and by cutting health inequalities. As a first step, we will carry out the biggest expansion of the workforce in the history of the NHS, doubling the number of medical school places, creating 10,000 more nursing and midwifery training places, recruiting 5,000 more health visitors, and doubling the number of district nurses. We will pay for this by scrapping the non-dom tax status, because we believe that people who come to live in the UK should pay their fair share of tax here. We read today in The Times that the NHS itself backs Labour’s plan, so why do the Government not back it?

Geoffrey Clifton-Brown: I listened very carefully to what the leader of the hon. Lady’s party said on the “Today” programme this morning. He said that any proposals he would include in his manifesto for the next general election would be properly costed. Has the hon. Lady properly costed the proposals that she has just outlined, and if so, how much will they cost?

Liz Kendall: Yes, we have properly costed these proposals, because we—unlike the hon. Gentleman’s party, which announced huge amounts of borrowing without saying anything about where the money would come from  under the former Prime Minister’s plans—will only set out our commitments when we can say where we will get the money from. We will get it by cancelling that non-dom tax status, and I urge the hon. Gentleman to encourage the Chancellor to follow that example in his Budget. I hope that when the Minister responds he will put the House and, more importantly, the public out of our misery. and just adopt Labour’s plan. If he does, he will surely have the backing of the Chancellor, who said only a few months ago that he very much hoped that the Government would adopt our proposals,
“on the basis that smart governments always nick the best ideas of their opponents.”
The truth is that Labour is proposing the solutions to the problems that the country faces because the Conservatives cannot be trusted to fix the mess that they have caused. Instead of introducing the long-term reforms that the country needs, they are constantly lurching from crisis to crisis—always reacting, always behind the curve. Every year there is a winter crisis, with more elderly people ending up stuck in hospital because they cannot get the social care and other local services that they need in the community or at home. Every year, people struggle to get the proper mental health support they need, so they end up reaching crisis point, which is worse for them and more expensive for the taxpayer. Every year, people are left hanging on the phone for hours and hours trying to get a GP appointment until there is no choice but for them to end up in A&E. Every year, there is a sticking plaster and never a cure. In contrast, Labour is calling for a 10-year plan of investment and reform to deal with the root causes of the challenges that we face and to build a care system fit for the future.
We will fix the front door to the NHS in primary care, recruiting more doctors to deliver better access to GPs, ensuring that patients can see the doctor they want in the manner they want—whether that is face to face, over the phone or online. We will fix the exit door out of the NHS and into social care, including by delivering a new deal for care workers so that they get the pay, the training and the terms and conditions that they deserve, which will mean that we can deal with the problem of delayed discharges.
We will recruit 8,500 mental health workers to provide faster treatment and also the support in schools that young people need, which will stop them from getting to crisis point, too. We will enshrine the principle of home first. Ultimately, what we need is a fundamental shift in the focus of care out of hospitals, into the community and more towards prevention. The big challenge that we face is an ageing population, with more people living with one, two, three, four or more long-term conditions. We must get that shift towards prevention. We must enable and support people to take more control over their health and care. We must have one team, with one point of contact, because people do not see their needs in the health or care silos. That is what Labour will deliver. When I first became an MP, I remember seeing in my own constituency people with the telemedicine that they needed to manage long-term conditions, such as chronic obstructive pulmonary disease. I remember visiting Totnes where there was a single, joined-up health and care team. I remember the sexual health and other support services from public health teams that Labour put in place, all of which, in my constituency, have disappeared.
I know from my time working for the last Labour Government that we cannot solve all the problems that the Tories have created overnight, but I also know—and Labour’s record in Government proves this—that with vision, determination and a clear plan, which is drawn up with the staff who provide the services and, crucially, with the users and their families, the NHS and our care system can be transformed. We have done it before. We stand ready to do it again, and Members on the Labour Benches will work day and night to deliver it.

Neil O'Brien: I am grateful to the hon. Member for Jarrow (Kate Osborne) for securing this very important debate. We have had a very large number of interesting and important speeches this afternoon—there are too many to list every single one of them. We had an important contribution from the former Health and Social Care Secretary, my right hon. Friend the Member for West Suffolk (Matt Hancock), about the importance of technology and building on the lessons of the vaccination campaign, which we are certainly doing. We had a very interesting intervention from the right hon. Member for Islington North (Jeremy Corbyn) who stressed the importance of housing for health. He is absolutely right about that, which is why we are taking forward the extension of the decent homes standard to the private sector and taking through the Social Housing (Regulation) Bill to fix some of those issues. My hon. Friend the Member for The Cotswolds (Sir Geoffrey Clifton-Brown) talked fascinatingly about the digital revolution in Denmark and the standardisation of new hospital builds there, which is something that we are in fact doing through Health 2.0. We are also looking at the discharge figures in his local area that he mentioned.
The hon. Member for Bolton South East (Yasmin Qureshi) talked about the dental reforms and said that they were only a starting point. I absolutely agree and will come on to that matter in a moment. My hon. Friend the Member for Delyn (Rob Roberts) talked about the challenges facing the NHS in Wales, reminding us that this is a common challenge across the UK. I can reassure my hon. Friend the Member for Christchurch (Sir Christopher Chope) that we are very interested in driving forward apprenticeship and non-degree routes into healthcare. We are extremely enthusiastic about that and I am happy to pursue that conversation with him after this debate.
Before I begin, I wish to pay tribute to our NHS and care workforce. Our staff work tirelessly to provide excellent care for patients, and our country is rightly very proud of them. The covid pandemic tested the NHS like never before, and all the NHS staff rose to meet those tests in extraordinary new ways. As we look to the future, we can take pride in the NHS’s response to covid-19, and take inspiration from the new and innovative ways of working that were born from the most difficult of times.
The NHS has certain foundation stones that we will never change, including being free at the point of use, regardless of income, and comprehensive services provided solely on the basis of need. It will never be for sale to the private sector. Of course we cannot just preserve the NHS; we need to make it fit for the future. The challenges  we face are changing, including an ageing population and the backlog created by covid, and the NHS needs to change with them.
Today I will talk about: finance and the workforce; supporting urgent care; cutting backlogs; and improving social care and primary care. Those are some of the issues raised by hon. Members this afternoon.
The spending review provided a record settlement to the Department over this Parliament, increasing core resource spending by £46.9 billion to £180.4 billion in 2024-25, to ensure long-term sustainable funding is available to support the NHS of the future. In addition, the Chancellor’s autumn statement made up to £14 billion extra available for the NHS and adult social care.
According to the King’s Fund, real-terms spending will have increased by about 42% between 2010 and the end of this Parliament. That funding, a record both in real terms and as a share of the economy, will enable us to ensure that the NHS has the long-term resources and workforce it needs, because our NHS would be nothing without our fantastic health and social care workers. That is why we are on track to recruit an extra 50,000 nurses by March 2024, and it is why we have already expanded medical training places by 1,500 a year, or 25%. We now have 35,000 more doctors and 47,000 more nurses working in the NHS than in 2010.
Alongside recruitment, training our existing workforce is hugely important. Ensuring the NHS is a workplace that provides the environment and flexibility to support long-term careers is a key priority, which is why there are now 900 more medical specialty training posts in 2023, including 500 in mental health and cancer treatment, in addition to the 700 additional specialty training posts that we funded in 2022 and the increase in GP training posts from 2,400 a year to a record 4,000 a year.
We are committed to further supporting our NHS staff to develop their skills and to deliver excellence to patients, which is why the Government have committed to publishing a long-term NHS workforce plan this year.

Liz Kendall: Will that long-term workforce plan include social care staff?

Neil O'Brien: It will be right across the piece. We have already set out some of our plans for social care, and the full details will hopefully be with the hon. Lady in the not-too-distant future.
The NHS recently published a delivery plan for recovering urgent and emergency care services. It is backed by record investment, including a £1 billion dedicated fund for hospital capacity over 2023-24. We will achieve these improvements by delivering 800 new ambulances and 5,000 more sustainable, fully staffed hospital beds, as well as an ambition to scale up innovative virtual wards, which are already making huge improvements, to support 50,000 people a month in their own home.
The number of ambulance and ambulance support staff is up by 40% since 2010. As well as having those extra staff, we are putting in an extra £50 million in capital funding to upgrade and expand hospitals, including with ambulance hubs and facilities for patients who are about to be discharged. That will free up hospital beds and address handover delays, helping to get those extra ambulances swiftly back on the road.
As well as getting people to hospital, we must further prevent the need for urgent care. That is why we extended vaccinations and are rolling out fall services across the country. We also need to improve the flow through hospitals, as the hon. Member for Leicester West (Liz Kendall) said, by investing in social care. I will say more about that in a moment.
Members know only too well the pressure that the pandemic put on the NHS. The number of people waiting more than 52 weeks for elective care rose from 1,468 in August 2019 to 436,000 in March 2021. In February 2022, the NHS published a delivery plan for tackling the covid-19 backlog, which set out a series of public commitments and initiatives to reduce the backlog. We met our first target by virtually eliminating waits of two years or more by July 2022—that is from a peak of 23,800 at the start of January 2022. To support that elective recovery and to cut backlogs, one of our top five priorities is to spend more than £8 billion from 2022-23 to 2024-25, in addition to the £2 billion elective recovery fund and the £700 million targeted investment fund made available last year. As well as having 4,800 more doctors and 10,900 more nurses than this time just last year, we have 89 new surgical hubs and 92 community diagnostic centres already up and running—the hon. Member for Stockton North (Alex Cunningham) talked about the one in his local area.
As part of this elective recovery, we continue to deliver the huge investment in mental health that was set out in the long-term plan for the NHS, with £2.3 billion extra by next year, supporting an extra 2 million people to get the treatment they need each year. Taken together, that elective funding could deliver the equivalent of about 9 million more checks and procedures, and means that the NHS in England is aiming to deliver about 30% more elective activity by 2024-25 than it was delivering before the pandemic—that is a huge increase. We are aiming to end 18-month waits by April and the NHS is making good progress towards that.
Turning to general practice and primary care, I know that GPs are under huge pressure, and I am incredibly grateful to them and their teams for their hard work. We are investing an extra £1.5 billion to create an additional 50 million general practice appointments a year by 2024. We are doing that by increasing and diversifying the workforce and we are well on our way to hitting that target. In December and indeed January, there were, on average, 1.34 million general practice appointments per working day, excluding the covid vaccinations that GPs are doing. That is about a 10% increase on pre-pandemic levels. GPs are doing more than ever before and a wider range of things than ever before, and they are really working hard.
Since 2019, we have recruited more than 2,000 more doctors into general practice and more than 25,000 additional clinical staff into general practice. So we are well on the way to hitting the 26,000 extra commitment that we made ahead of schedule. They are covering a wide range of extra roles, from pharmacists to physios, mental health specialists and more. So GPs are now effectively leading a diverse team with many different specialist skills. We also had a record-breaking number starting training as GPs last year—it is up from about 2,400 a year to 4,000 a year now. As we committed to do in our plan for patients, we have amended funding rules to bolster general practice teams with new roles. We have  increased the clinical services available from community pharmacies already and we are looking at how we can go further. We have introduced new digital tools and improved IT systems, where, again, we are looking to go further.
Of course, we know we need to do more. In the autumn statement, we committed to creating a recovery plan for primary care that addresses the challenges facing general practice. That plan will aim to make it easier for the public to contact their practice and easier for practices to see their patients sooner. That is due to be published in the coming weeks.

Kate Osborne: Can the Minister clarify something for me? He talks about the workforce plan. Can he tell us whether it is fully funded and whether it includes social care?

Neil O'Brien: It will be about both what is needed over time—some of the time horizons might be longer—and what we are going to do about it.
Let me complete the thought about primary care—

Kate Osborne: Will the Minister give way again?

Neil O'Brien: I want to make a bit of progress. I am sorry, but I will perhaps come back to the hon. Lady in a bit.
Let me complete the thought on primary care. We will also be saying more about dentistry, which was an issue raised by the hon. Member for Bolton South East. She mentioned some of the reforms that we made. We are trying to make dental practice more attractive. We started reforming the contract and creating more unit of dental activity bands to better reflect the fair cost of NHS work and so incentivise it. We have introduced the minimum UDA value to help where it is particularly low. We are letting dentists deliver 110% of their contracted UDAs to encourage more activity. We have changed the law to make it easier for overseas dentists to do NHS work here, which someone mentioned earlier. Plans are advancing for centres for dental development in Ipswich and places such as Cumbria. But there is much more to do, as the hon. Lady said, and we will be saying more about that soon.
On adult social care, we are taking decisive action, with record investment, making available up to £7.5 billion over the next two years to support adult social care and discharge. That historic funding boost—that record investment in adult social care—will put the system on a much stronger financial footing and help local authorities to address pressures in the sector.

Liz Kendall: The Minister has repeatedly used this £7.5 billion extra for social care figure, but will he confirm that £3.15 billion of that is from the Government’s failure to implement the cap on care costs and postponing the right of self-funders to have their care funded at local authority level, and that £1.75 billion of it is from the social care precept? In other words, this is a tax on ordinary people—it is not coming from the Government as new money.

Neil O'Brien: Is that not a revealing comment from the Opposition? The Government do not have any money. All this spending comes from hard-working  taxpayers, and the Conservative party wants to keep the burden of tax down. On the hon. Lady’s point about the other pot of spending, we chose to prioritise funding through the frontline. That is our choice and it is one we will defend because we know we urgently need to improve social care—[Interruption.] It is tax, yes. All Government spending comes from tax, that is correct, and the idea that that is in some way a revelation speaks volumes about where the Opposition are.
In December 2021, “People at the Heart of Care: adult social care reform” was published, setting out a 10-year vision for reforming adult social care. We have made good progress over the last year on some of the commitments in that White Paper. We invested £100 million to begin implementing reforms on digitisation and technology, local authority oversight and new data collections and surveys, so that people working in the NHS and adult social care have improved access to the information they need to ensure personalised, high-quality care. The Carer’s Leave Bill, currently going through Parliament, will introduce a new leave entitlement as a day 1 right, available to all employees who are providing care for a dependant with a long-term care need. We will set out our next steps on social care soon.
We are committed to supporting our NHS by putting in place the investment and reform to secure its future and we will bring forward a workforce plan later in the year. We are building back better from the pandemic.

Alex Cunningham: I got the impression the Minister was winding up; I just ask him to commit to looking at the issues I raised in my speech about the secret report into the activities of North Tees and Hartlepool NHS foundation trust.

Neil O'Brien: I am happy to make that commitment.

Christopher Chope: The Minister has not covered the issue of productivity. He has mentioned, quite rightly, that the Government do not have any money. It is our money, taxpayers’ money, so why are the taxpayers not allowed to have access to these issues in the NHS with lack of productivity?

Neil O'Brien: I am as keen as my hon. Friend to explore all those different things and I am happy to take them up with him following this debate. Many things I have been talking about in this speech, the new technology we are putting in for GPs and the new ways of working, are crucial not just to getting taxpayers better value for money, but to protecting the NHS in the long term by enabling people to do more. The NHS is an enormous source of pride in this country. It is free at the point of delivery and it always will be, giving high-quality care for all. That remains our enduring commitment to our national health service.

Nigel Evans: The final word goes to Kate Osborne.

Kate Osborne: I thank everyone who has contributed today. I also thank all NHS staff who are taking industrial action to save our health services. No one takes strike action lightly, especially those who are caring for the most vulnerable in society, but this Government have  left them with no choice. I thank the campaigners who are out every week, highlighting the impact that 13 years of Conservative Governments have had on our NHS. Those groups would not be necessary if this Government were funding the NHS properly, but they are necessary.
Across the country, there are groups, including the Save South Tyneside Hospital Campaign in my Jarrow constituency, campaigning to save hospital services and calling for the Government to fund the NHS properly. I also thank the organisations that got in touch ahead of the debate, including Diabetes UK, the British Dental Association, Age UK, the Royal College of General Practitioners, the British Heart Foundation, the Cystic Fibrosis Trust, the Royal College of Ophthalmologists, Keep Our NHS Public, Parkinson’s UK, the MS Society UK, Cancer Research UK, the Royal College of Paediatrics and Child Health, Your NHS Needs You and the trade unions.
Health spending in the UK is 18% below the EU14 average. The UK would have needed to spend £40 billion more a year every year for the past 10 years to keep up. That shows just how far behind we have fallen. The root cause of this crisis is that the Conservatives have failed to provide the NHS with the resources and staff it needs to treat patients on time. Labour will train a new generation of NHS staff, paid for by abolishing the non-dom tax status, so that the NHS has the workforce it desperately needs. As the shadow Minister, my hon. Friend the Member for Leicester West (Liz Kendall), said, why will the Government not commit to doing that, as the Chancellor has suggested?
I thank all who contributed to the debate, which has highlighted a number of urgent requirements of the Government to secure the future of our NHS, including increased funding, the accountability of the private sector, a fully funded workforce strategy and a strategy to deal with health inequalities. I hope that the Minister has listened—I am not sure as he has not made eye contact with many Members—because without immediate action, we will see thousands more avoidable deaths, including the death of our NHS.
Question put and agreed to.
Resolved,
That this House has considered the future of the NHS, its staffing and funding.

Business without Debate

Deputy Speakers

Ordered,
That, further to the Order of 30 January, paragraphs (1) and (2) of the Order of 19 December 2022 relating to the appointment of Sir Roger Gale as Deputy Speaker and to the exercise of the functions of the Chairman of Ways and Means shall continue to have effect for the remainder of this session.—(Jacob Young.)

Brendan Clarke-Smith: On a point of order, Mr Deputy Speaker.

Nigel Evans: Mr Clarke-Smith, am I correct in thinking that the point of order you wish to make is in relation to a shooting incident in Northern Ireland recently?

Brendan Clarke-Smith: It is.

Nigel Evans: In which case, let me say that I will take no points of order on that matter, and, owing to the sensitivities of the nature of that case and the ongoing police investigation, I certainly will not make a ruling on that issue from the Chair, other than to say that I am sure that the thoughts of all of us in this House are with John Caldwell and his family, and that our grateful thanks go to those who assisted him with first aid at the scene of the incident.

MPs and Second Jobs

Motion made, and Question proposed, That this House do now adjourn.—(Jacob Young.)

Richard Burgon: I have secured this debate to consider the urgent need to put an end to the ongoing scandal of MPs using their positions to enrich themselves through second jobs.
Being a Member of Parliament is a privilege. It is a well-paid job, and it is also a full-time job, so when MPs chase corporate cash, they are actually short-changing the public who pay them. That is why I introduced the Members of Parliament (Prohibition of Second Jobs) (Motion) Bill, which would ban MPs from having second jobs. I introduced that Bill soon after the issue of MPs’ second jobs shot to prominence through the Owen Paterson lobbying scandal. That case became a lightning rod for public anger not just about corporate lobbying, but about the wider dodgy deals and crony contracts that the Government were mired in.
That scandal should have been the moment when the Government cleaned the stables and took real action to prevent the corrosive influence of MPs’ second jobs. Has the problem gone away more than a year since that scandal came to light? No. In fact, it has only got worse. There has been the illusion of action so that the Government could draw a line under the issue, but an investigation by The Observer found that, one year after the Owen Paterson scandal, MPs were earning more than ever from second jobs. When scandals happen and real action is promised, what message does it send to the public if the problem is instead allowed to get worse?
The latest figures, from January, show that MPs have earned more than £17 million on top of their salaries since the last general election, and that Conservative MPs have taken nearly 90% of it. Around two thirds of that money went to just 20 MPs, of whom 17 were Conservative Members. I invited the top 10 highest outside earners to intervene in the debate because I wanted to give them the chance to defend the right of MPs to continue raking it in from outside earnings. It appears none of them has taken me up on my offer, which is a shame.
I am disappointed that the former Prime Minister, the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), is not here today. Under his Government, the Tories repeatedly blocked my Bill banning second jobs. Time after time, his Government blocked any meaningful action against second jobs, and no wonder—the former Prime Minister is now the highest earning MP, having made nearly £5 million in outside earnings since leaving Downing Street last September. It would take the average nurse around 150 years to make what the former Prime Minister has made in just six months, and it is 50 times more than his MP’s salary.
Those who earn more from their outside earnings than they do as MPs all too often seem to view being an MP as their second job. Over the last year, as I have pushed my Bill in this House, I have heard some truly laughable attempts to justify MPs chasing corporate cash. Government Members used to tell me that my Bill would deprive our Parliament of the real world experience provided by second jobs, which bring us closer to people out there. Isn’t it funny how the Government Members who justify the racket of second jobs never choose to  work for low wages in supermarkets, as bus drivers or in care homes—jobs done by millions of people who we are here to represent?
Instead, we have examples such as the former Chancellor and Health Secretary, the right hon. Member for Bromsgrove (Sajid Javid), who earned £1,500 an hour advising a US investment bank. These are not the jobs or experiences of most people. Big money second jobs like that do not make MPs more in touch with the real world. They do the exact opposite, adding to the sense of an out-of-touch political class that, I am afraid, is increasingly held in contempt by the public. We have even had Conservative MPs claiming:
“There’s no way I could be an MP without my outside interests. My wife works full time, I’ve got kids and need the money for childcare.”

Alex Burghart: I am enjoying the hon. Gentleman’s speech. He has ascribed a quotation to a Conservative MP. Would he mind saying who it came from, so that we know it is not just a vague assertion or a hypothetical Conservative MP?

Richard Burgon: I believe that it was provided anonymously to the press when this Conservative MP was pleading poverty on £84,000 a year but did not want their constituents to know they were doing so. The Minister is mistaken if he thinks that that quote is somehow unrepresentative of an attitude.
How on earth do these people think that the rest of the population, who are earning way below £84,000 a year, cope? These are the same MPs, by the way, who are all too happy to vote through swingeing cuts to benefits and to suppress the wages of workers who earn far less than they do.

Kate Osborne: The former PM earned £5 million while remaining an MP, and MPs have raked in £17 million from second jobs since the last election. Does my hon. Friend agree that their time would be better spent in their constituencies, looking after their constituents and dealing with the cost of living crisis that we are in?

Richard Burgon: My hon. Friend is correct. It is even worse that this racket is taking place during a cost of living crisis, when we have seen a proliferation of food banks—we see Tory MPs raking it in while some Tory MPs even deny the need for food banks.
Many MPs seem to fail to understand that they already earn more than 95% of the public. If they do not get how well paid they are compared with the rest of the public, or if they are not happy with their salary, perhaps they are in the wrong job. Given that our job is to represent the people, perhaps our democracy would be better served by MPs who better reflect 95% of people in this country. Having MPs who are seen to be using their position not to serve the public, but to fill their own pockets is fuelling a lack of trust in our political system. People raise important questions about who MPs are there to serve: they rightly ask whether, if an MP is getting paid tens of thousands of pounds, that MP can really claim to be representing the public and not their other employer.
Despite what many may tell themselves, the truth is that MPs are being paid not for what they know, but for who they know. They would not get those vast sums from big corporations if they were not MPs with political connections, which creates obvious conflicts of interests. MPs’ second jobs are an especial danger to our democracy, given that trust in politicians is already at the lowest level on record. Two in three people now see politicians as merely out for themselves, while just one in 20 people think that politicians are in the job primarily to serve the public good. More than 60% of the public think that if an MP is being paid to do another job, that prevents them from being independent and able to make the right decisions as an MP. Banning second jobs is one way in which the Government can prove to the public that MPs are not just in it for themselves, and that they really are making decisions based only on what they believe is best for the people of this country. The majority of people in this country want a ban on MPs earning money from second jobs, and only a tiny minority—just 19%—support MPs’ second jobs. MPs need to wake up to the reality of that public feeling and public opinion.
So what is the way forward? My Bill to ban MPs’ second jobs could be an important first step in the long road towards a more transparent and healthy democracy. My Bill is clear and bold: no paid second jobs for MPs at all, except in very limited circumstances.

Alex Burghart: Could the hon. Gentleman set out what those exceptions would be? I am afraid that I cannot remember from his Bill.

Richard Burgon: I will set out the exceptions that my Bill outlines. I am disappointed that the Minister does not know the detail of my Bill, since his Government repeatedly blocked it. I thought they must have read it very carefully in order to repeatedly block its passage through Parliament.
My Bill adds a new punishment for breaking second jobs rules: a fine at least equal to the amount paid to the offending Member for their second job, removing any financial gain from breaking the rules. That is in addition to existing sanctions that the Standards Committee can recommend, which include suspension. Some will argue that my Bill is very tough—indeed it is, because it has to be. We need to cut the rot out of our politics. The very limited exemptions I have included are when a second job is about maintaining professional qualifications, such as in nursing, or when a Member is working on the frontline in our NHS—as a doctor, for example—or in another emergency service. Those roles are about genuine public service and public interest, and have nothing to do with the scandal that has been shaking Parliament and sowing such distrust in politicians.
Some MPs have asked me how my Bill would impact on ministerial or Select Committee roles. Of course, it would not do so, because those additional roles are a key part of our democratic functioning in which we are trying to rebuild trust. My Bill would also allow MPs to carry out certain paid work, such as media appearances or speeches, if that entire outside earning is donated to charity. That way, we can be sure that those activities are about public service, not private enrichment.

John Martin McDonnell: Hillingdon Council, within which the Uxbridge constituency is contained, is going through one of the most massive cutbacks of its voluntary sector at the moment, including the local autistic group, Samaritans and others. Would it not be really helpful if the £5 million that the right hon. Member for Uxbridge and South Ruislip (Boris Johnson) earned was donated to those charities?

Richard Burgon: My right hon. Friend makes a fantastic suggestion. Why does the former Prime Minister not donate that £5 million to these important causes in his constituency? Let us invite him to do so and see what he does.
To conclude, banning second jobs for MPs is an important step to restoring the integrity of our democracy. No one can serve two masters, and MPs’ priority must be their constituents. I am afraid that the time for half measures and empty promises on this issue has long passed. The Labour party has proposed a ban on second jobs for MPs, with exemptions for public services similar to those in my Bill. I will be proud to join my colleagues in voting through that ban if, as gladly appears likely, we are voted into power at the next general election. An election could be up to 18 months away, however, and there is no justification for allowing this scandal to carry on a moment longer. There is nothing stopping the Government from taking action to stop the rot now.
The people out there believe that MPs’ second jobs have to go, and no amount of clever wording, sophistry and non-representative examples can change that reality. The people—the public—rightly believe that MPs should be committed to public service, not personal gain. Each delay in action further damages trust and exposes the integrity of our democracy to yet more scandals in future. It is time to end the gravy train of MPs’ second jobs.

Alex Burghart: I congratulate the hon. Member for Leeds East (Richard Burgon) on securing the debate. It is a pleasure to be in an Adjournment debate with him again; I sometimes think that only he and I care about these issues—and the hon. Member for Jarrow (Kate Osborne), of course. I enjoyed listening to his speech and I know that his views come from a well thought out and sincere position; I reassure him that the Government’s do too. We recently considered many of the issues that have been raised—he will have been present in those debates.
We firmly believe, as the hon. Gentleman does, that an MP’s primary job is to serve their constituents. It is at the will of our constituents that we all sit here and without their support, we are nothing. We on the Conservative Benches also appreciate that the issue of outside or additional earnings is complex, and it has been considered by the Standards Committee, as he will be aware. That is why we have continued to support the clarification and improvement of the rules in the code of conduct to ensure that Members’ interests are properly declared and that the ban on paid advocacy and lobbying is strengthened, as was decided by the House in December 2022.
At that time, the question was raised about whether work undertaken outside should be limited. We believe that the responsibility for considering what constitutes a reasonable limit is a matter for individual Members; or to put it another way, it is a matter for their constituents. As I have said, ultimately, it is our constituents to whom  we must answer—not to the hon. Gentleman, the Leader of the Opposition, the Government or even the House of Commons. That is why the Government came to the view that we would support the work that has been undertaken to introduce robust new measures to strengthen the standards system in Parliament and to ensure that the rules prohibit Members from using their parliamentary role to benefit private interests rather than their constituents’ interests.
We remain of the view that, as the Committee on Standards in Public Life recommended in 2018, Members should be banned from accepting any paid work to provide services as a parliamentary strategist, adviser or consultant. That is why the Government brought forward an amendment, which the House approved on 17 November 2021, to support the introduction of limits on Members undertaking outside work. These were that MPs should be prohibited from any paid work to provide services, as I have said, as a parliamentary strategist, adviser or consultant, and that outside work should be undertaken only within reasonable limits. The Government believe that an outright ban on second jobs is unnecessary as a consequence, as the rules in the code of conduct effectively address concerns about paid advocacy and emphasise the duty of MPs to properly serve their constituents and represent their interests in Parliament.
The hon. Gentleman made a number of good points, and he made a valid argument which, if he will forgive me, I will paraphrase. It was that it is a privilege to be here, and Members should not be spending their time on issues that are not associated with their constituents’ needs and should not be allowed to earn large sums of money by doing other things. One day, there might be a Labour Government—God help us—and when that happens, there is a chance that he might be sitting on this Front Bench, and at that point he will have a second job. Even though he would not ban that under his Bill, if his argument is about time, I point out that there is no second job or outside interest that could possibly compete with the amount of time that a Minister is expected to spend on their job, as he will see if ever he sits on the Treasury Bench. I confess that being a Minister reduces the amount of time Members have to spend on the needs of our constituents; it really does. We do it—it is an honour, a privilege and a pleasure—but it would be a lie to say that Members have as much time to spend on their constituency work when they are a Minister as they do when they are a Back Bencher. So the argument on time does not stand up on its own.
On the argument about money, the hon. Gentleman made it clear that he finds the fact that some Members of this House earn a great deal of money unpalatable and unsavoury, and he is entitled to those views. However, it is not for him to decide whether that should rule out such a person from being an MP. The people who get to decide that are not him or even the Government; those who should have the final say on whether such a person is an MP are their voters. Deep down, he knows that too, because I know that he is a democrat at heart, and he believes that sovereignty rests with the people. I do too, and I do not want to see a Government passing legislation that starts to make decisions for voters. Voters should have the final say: let them make their decisions.

Richard Burgon: I thank the Minister for responding in such a serious and considered way on this issue. I get the impression that he will not be supporting my Bill to  ban MPs’ second jobs. He refers to constituents and the public as sovereign, and I agree. What about this for an idea, then? If the Government are not prepared to ban second jobs, as I think they should, what about passing legislation to ensure that the outside earnings of every MP are listed under their name on the ballot paper at a general election? Constituents could then have a look and decide whether they want to vote for a person to carry on being their MP.

Alex Burghart: The hon. Gentleman might find, if he did that, that people would be asking for a lot of other information to be published about Members at the ballot box. The public are perfectly capable and willing to find out about people they vote for, as he will know from knocking on doors. In my experience, voters are often very well informed and do not vote blindly. Consequently, although he says that the public support the thrust of his Bill, I put it to him that the public have also voted repeatedly over many years for Members with outside interests, when they have often had a choice not to do so. We should all respect their decision, because it is their decision.
The hon. Gentleman says that changing the law in this way would make this House more representative of people in the country. Often when I voted before I was a Member of this House, I did not vote for people like me. I made a choice to vote for the best candidate regardless of their background. Again, there are some things that are right for us to debate, but that are not right for us to decide. We must leave these decisions in  the hands of the voters. Of course, such a system can only work when we have transparency, and it is transparency that this Government have supported and will continue to support.
I thank the hon. Gentleman for his thoughts, and I hope he will forgive me for not being able to recall the particular exemptions that he set out in his Bill. I thank him for his interest in this subject, but I am afraid that we will have to agree to disagree.

Nigel Evans: Before I put the question, I want to intrude a little on the debate to say that this weekend is WorldPride in Sydney, Australia. Hundreds of thousands of people from all over the world will be gathering to celebrate the festivities there, including mardi gras. [Interruption.] The Minister asks whether I will be one of them—I went to WorldPride in New York just before covid, and it was glorious and fantastic. The hon. Members for Jarrow (Kate Osborne) and for Redcar (Jacob Young) and I have all agreed that we would love to be there this weekend, but someone has to keep the show on the road, particularly on Friday. We want to send a clear message to all those celebrating. I have seen the Sydney opera house lit up with all the flags encompassed in the pride movement, and it looks fantastic. It will be superb weather, because it is Australia. They will have a fantastic time and we want to say from the House of Commons in the United Kingdom that we share your pride.
Question put and agreed to.
House adjourned.